血淋巴细胞与单核细胞比值与前列腺癌临床病理特征关系及其早期去势抵抗预测价值分析

Relationships between monocyte-to-lymphocyte ratio and clinicopathological features of prostate cancer and the predictive value of early castration resistance

目的探讨血淋巴细胞与单核细胞比值(LMR)与前列腺癌(prostate cancer,PCa)临床病理特征关系及其对早期去势抵抗预测价值。方法选取2010年1月—2014年12月四川省攀枝花市中心医院收治的PCa患者98例,根据LMR值分为升高组(LMR≥2.7)和降低组(LMR<2.7)。采用回顾性分析法分析所有患者的临床及随访资料,记录所有患者其LMR值的大小、年龄、肿瘤情况以及其早期去势抵抗情况,并比较不同LMR值患者间其上述资料间的差异。结果本组98例PCa患者中进展为早期去势抵抗性PCa(stration resistant prostate cancer,CRPC)有43例,占43.88%,其中22例患者在随访1年内进展为CRPC,占22.45%;2组患者在肿瘤浸润深度、淋巴结和骨转移、肿瘤分期、大小、分级、Gleason评分、mGPS评分和CRPC发生率间均差异有统计学意义(P<0.05);通过Spearman等级相关分析可得,LMR大小与肿瘤浸润深度、肿瘤分期、肿瘤大小及肿瘤分级和Gleason评分及mGPS评分之间均呈负相关(P<0.05);经非条件单因素Logistic回归模型分析显示,PCa患者其不同肿瘤浸润深度、淋巴结和骨转移、肿瘤分期、Gleason评分、mGPS评分和LMR大小间CRPC发生率差异均有统计学意义(P<0.05);经非条件多因素Logistic回归模型分析进一步证实得,肿瘤浸润深度、淋巴结转移个数、骨转移、Gleason与mGPS评分和LMR大小均为导致CRPC出现的独立危险因素(P<0.05)。结论 LMR与PCa患者其肿瘤浸润深度、肿瘤分期、肿瘤大小及肿瘤分级和Gleason与mGPS评分等病理特征间均呈负相关,且为导致CRPC出现的独立危险因素。

ObjectiveTo investigate the relationships between the ratio of blood lymphocytes to monocytes（LMR）and the clinicopathological features of prostate cancer（PCa）and its predictive value for early castration resistance. MethodsNinety-eight patients with PCa treated in our hospital between January 2010 and December 2014 were selected as the subjects, whose LMR value, age, tumor status and early castration resistance were recorded. The difference in the above data between patients with different LMR values was compared. ResultsAmong the 98 cases of PCa, 43 patients （43.88%） developed CRPC, 22 of whom progressed to CRPC during one-year follow-up, accounting for 22.45%. Spearman rank correlation analysis showed that the size of LMR was negatively correlated with tumor invasion depth, tumor staging, tumor size, tumor grade, Gleason score and mGPS score（P〈0.05）. Single factor non conditional logistic regression analysis showed that patients with PCa were significantly different in the depth of tumor invasion, lymph node and bone metastasis, tumor staging, Gleason score, mGPS score and LMR（P〈0.05）. Multi factor non conditional logistic regression analysis offered more evidence that the depth of tumor invasion, lymph node metastasis, bone metastasis, Gleason and mGPS scores and LMR size were independent risk factors for CRPC（P〈0.05）. ConclusionFor patients with PCa, LMR is negatively correlated with the depth of tumor invasion, tumor staging, tumor size, tumor grade, Gleason and mGPS scores, which might be independent risk factors for CRPC.