术前FIB和PLT检测对上尿路尿路上皮癌病人预后评估价值

VALUE OF PREOPERATIVE FIB AND PLT IN ASSESSING THE PROGNOSIS OF PATIENTS WITH UPPER URINARY TRACT UROTHELIAL CARCINOMA

目的探讨术前纤维蛋白原(FIB)和血小板(PLT)计数评估上尿路尿路上皮癌(UUTUC)病人预后的价值。方法回顾性分析2005年1月—2011年12月于我院行手术治疗的140例非转移性UUTUC病人的临床资料。比较术前不同FIB和PLT水平病人临床病理特征的差异,应用Kaplan-Meier法和Log-rank检验进行生存分析,应用Cox比例风险回归模型进行预后的危险因素分析。结果低FIB(<4.0g/L)组与高FIB(≥4.0g/L)组病人临床病理特征比较,仅病理分期差异有统计学意义(χ2=7.241,P<0.01)。高PLT组各临床病理指标与低PLT组比较差异均无显著性(P>0.05)。低FIB组与高FIB组肿瘤特异性生存率和无复发生存率差异有统计学意义(χ2=8.192、7.162,P<0.05)。病理分期、术前FIB是病人肿瘤特异性生存的独立危险因素(HR=13.097、0.429,P<0.05)。结论术前FIB是UUTUC病人肿瘤特异性生存的独立危险因素,术前FIB≥4.0g/L的病人预后差。术前PLT计数对UUTUC病人预后无明显影响。

Objective To investigate the value of preoperative fibrinogen（FIB）and platelet（PLT）count in assessing the prognosis of patients with upper urinary tract urothelial carcinoma（UUTUC）.Methods We retrospectively analyzed the clinical data of 140 patients with non-metastatic UUTUC who underwent surgical treatment in our hospital from January 2005 to December 2011.Clinicopathological features were compared between patients with different preoperative FIB levels and PLTs.Survival analysis was performed using Kaplan-Meier method and log-rank test,and risk factor analysis was performed using the Cox proportional hazards regression model.Results There was only a significant difference in pathological staging between low-FIB group（4.0 g/L）and high-FIB group（≥4.0 g/L）（χ^2=7.241,P〈0.01）.However,there was no significant difference in each clinicopathological feature between high-PLT group and low-PLT group（P〈0.05）.There were significant differences in cancerspecific survival rate and recurrence-free survival rate between low-FIB group and high-FIB group（χ^2=8.19,7.162;P〈0.05）.Pathological staging and preoperative FIB were independent risk factors for cancer-specific survival（HR=13.097 and 0.429,both P〈0.05）.Conclusion Preoperative FIB is an independent risk factor for cancer-specific survival in patients with UUTUC.Patients with high preoperative FIB levels（≥4.0 g/L）have poor prognosis.Preoperative PLT has no significant effect on the prognosis of patients with UUTUC.