术前外周血血小板与淋巴细胞计数比在预测甲状腺髓样癌患者淋巴结转移中的价值

Value of preoperative platelet-to-lymphocyte ratio in predicting lymph node metastasis for patients with medullary thyroid carcinoma

目的分析术前外周血血小板与淋巴细胞计数比(platelet-to-lymphocyte ratio,PLR)在预测甲状腺髓样癌患者淋巴结转移中的价值。方法回顾性分析2001年1月-2017年6月在本院初次确诊的63例甲状腺髓样癌患者的临床病历资料,通过ROC曲线分析寻找PLR预测淋巴结转移的最佳Cut-off值,再通过单因素及多因素Logistic回归分析得出甲状腺髓样癌淋巴结转移的危险因素。结果根据ROC曲线分析得出预测甲状腺髓样癌淋巴结转移的PLR最佳cut-off值是107.955。多因素Logistic回归分析显示,肿瘤甲状腺外侵犯(OR:4.255,95%CI:1.158～15.640)、PLR≥107.955(OR:8.384,95%CI:1.934～36.353)均是淋巴结转移的独立预测因素。结论甲状腺髓样癌患者术前外周血PLR值可辅助预测淋巴结转移,高PLR值预示患者淋巴结转移概率较大。

Objective To investigate the predictive value of preoperative platelet-to-lymphocyte ratio (PLR)for lymph node metastasis (LNM)in medullary thyroid carcinoma (MTC)patients.Methods Sixty-three patients diagnosed with MTC in Chinese PLA General Hospital from January 2001 to June 2017 were included in our study.Receiver operating characteristic (ROC)analysis was performed to identify optimal PLR cut-off value,and the related influencing factors of LNM were screened using univariate and multivariate logistic regression analyses.Results The optimal cut-off value of the PLR for predicting LNM obtained from receiver operating characteristic curve analysis was 107.955,with sensitivity of 63.0% and specificity of 94.1%,and the area under the curve was 0.775.Multivariate analysis showed that extrathyroid extension (OR,4.255;95%CI,1.158-15.640) and the PLR ≥107.955 (OR,8.384;95%CI,1.934-36.353)were independent predictive factors of LNM.Conclusion Preoperative PLR is related to LNM in patients with medullary thyroid carcinoma.Furthermore,high value of PLR confers a high risk of LNM.