术前血小板平均体积在肾细胞癌患者预后中的价值

Value of preoperative mean platelet volume in prognosis of patients with renal cell carcinoma

目的探讨术前平均血小板体积(mean platelet volume,MPV)与肾细胞癌(renal cell carcinoma,RCC)术后生存率的关系。方法选取2013年1月~2016年12月行腹腔镜肾肿瘤根治术治疗的104例RCC患者进行回顾性分析。评估术前MPV对其预后生存率的影响。通过接受者操作特性曲线(ROC曲线),确定MPV最佳截断值。将患者分为低MPV组(MPV<9.75 fL)和高MPV组(MPV≥9.75 fL),应用Kaplan-Meier模型评估两组患者生存情况,并用COX比例风险模型对术后生存率进行单因素及多因素分析。结果104例患者中,低MPV组患者32例(30.8%)、高MPV组患者72例(69.2%)。Kaplan-Meier分析显示,低MPV组术后生存率明显低于高MPV组,差异有统计学意义(P<0.05);进一步进行COX多因素分析后发现,术前MPV可成为RCC患者术后生存率的独立危险因素(P=0.028)。结论对于RCC术后患者,术前MPV可作为术后预期生存的独立预测指标。

Objective To investigate the relationship between mean platelet volume(MPV)before surgery and survival rate of renal cell carcinoma(RCC).Methods A total of 104 RCC patients who underwent laparoscopic radical nephrectomy from January 2013 to December 2016 were retrospectively analyzed.The effect of preoperative MPV on prognosis and survival was evaluated.The optimal cut-off value of MPV was determined by receiver operating characteristic curve(ROC curve).The patients were divided into the low MPV group(MPV<9.75 fL)and the high MPV group(MPV≥9.75 fL).Kaplan-meier model was used to evaluate the survival of the two groups,and univariate and multivariate analysis of postoperative survival were conducted by COX proportional hazard model.Results Among the 104 patients,32(30.8%)were in the low MPV group and 72(69.2%)were in the high MPV group.Kaplan-meier analysis showed that postoperative survival rate in the low MPV group was significantly lower than that in the high MPV group(P<0.05).Further COX multivariate analysis showed that preoperative MPV was an independent risk factor for postoperative survival of RCC patients(P=0.028).Conclusion For RCC patients,preoperative MPV can be used as an independent predictor of postoperative survival.