摘要
目的:探讨平均血小板体积(MPV)和循环肿瘤细胞(CTCs)对结直肠癌患者术后复发转移的预测价值。方法:纳入2016年6月—2017年6月接受根治性手术治疗的100例结直肠癌患者作为研究对象,记录患者一般临床病理资料、肿瘤标志物、术前MPV、术前及术后2周CTCs以及根治术后5年内肿瘤复发转移情况,多因素Cox回归分析获得独立预测因素,重点分析MPV及CTCs与患者术后肿瘤复发转移的相关性,基于MPV及CTCs建立相关Cox复发转移风险得分模型,并绘制MPV及CTCs用于预测结直肠癌患者术后肿瘤复发转移净收益率的决策曲线,进一步验证MPV及CTCs的预测效能。结果:多因素分析结果显示,中分化(β=0.554,HR=1.546)、低分化(β=1.017,HR=2.841)、TNM/T分期(β=1.554,HR=6.552)、淋巴结转移(β=1.215,HR=4.312)、术后CTCs(β=1.235,HR=4.415)以及MPV(β=0.578,HR=1.615)为影响患者术后5年肿瘤复发转移的独立预测指标(P<0.05)。Cox复发转移风险得分模型显示,MPV及CTCs与Cox复发转移风险得分呈正相关(r=0.812、0.765,P均<0.001),与患者无病生存时间呈负相关(r=-0.817、-0.772,P均<0.001),决策曲线分析显示,分化程度、TNM/T分期、淋巴结转移、术后CTCs以及MPV预测患者术后肿瘤复发转移均具有良好的净收益率,联合预测的净收益率大于单一指标,净收益率最大值为0.278,高风险阈值为0.062~0.992。结论:结合术后Cox复发转移风险得分模型,CTCs及MPV对于结直肠癌患者术后复发转移具有较高的预测价值。
Objective:To investigate the predictive value of mean platelet volume(MPV)and circulating tumor cells(CTCs)in postoperative recurrence and metastasis of colorectal cancer patients,and to establish the related Cox risk score model.Methods:100 colorectal cancer patients who received radical surgery in our hospital from June 2016 to June 2017 were included as the subjects of study.The general clinicopathological data,tumor markers,preoperative MPV,preoperative and postoperative CTCs,and tumor recurrence and metastasis within 5 years after radical surgery were recorded.Multifactor Cox regression analysis obtained independent predictors,focusing on the analysis of the correlation between MPV and CTCs and postoperative tumor recurrence and metastasis,Based on MPV and CTCs,establish relevant Cox recurrence and metastasis risk score model,and draw a decision curve for MPV and CTCs to predict the net return rate of tumor recurrence and metastasis in colorectal cancer patients after surgery,to further verify the prediction efficiency of MPV and CTCs.Results:Multivariate analysis showed that mesodifferentiation(β=0.554,HR=1.546),poorly differentiated(β=1.017,HR=2.841),TNM/T stage(β=1.554,HR=6.552),lymph node metastasis(β=1.215,HR=4.312),postoperative CTCs(β=1.235,HR=4.415)and MPV(β=0.578,HR=1.615)were independent predictor of tumor recurrence and metastasis in patients 5 years after surgery(P<0.05).Cox recurrence and metastasis risk score model showed that MPV and CTCs are positively correlated with Cox recurrence and metastasis risk score(r/P=0.812/0.000,0.765/0.000),and negatively correlated with disease-free survival time(r/P=-0.817/0.000,-0.772/0.000).Decision curve analysis showed that differentiation degree,TNM/T stage,lymph node metastasis,postoperative CTCs,and MPV predict tumor recurrence and metastasis in patients with good net returns,the net return rate of the joint forecast was greater than that of a single indicator.The maximum net return rate was 0.278,and the high risk threshold was within the range of
作者
伍远浩
黄平
李来春
WU Yuan-hao;HUANG Ping;LI Lai-chun(Department of Anorectal Surgery,Hainan Provincial People's Hospital,Haikou 570311,China;Department of Nuclear Medicine,Hainan Provincial People's Hospital,Haikou 570311,China)
出处
《中国现代普通外科进展》
CAS
2023年第11期873-877,共5页
Chinese Journal of Current Advances in General Surgery
基金
海南省卫生健康行业科研项目(ZDYF2018152)。
关键词
平均血小板体积
循环肿瘤细胞
结直肠肿瘤
复发
转移
Mean platelet volume
Circulating tumor cells
Colorectalcancer
Recurrence
Metastasis
