纤维蛋白原与前白蛋白比值对中晚期非小细胞肺癌预后作用的研究

Prognostic value of fibrinogen-to-prealbumin ratio in patients with advanced non-small cell lung cancer

目的探讨纤维蛋白原(FIB)与前白蛋白(PA)比值(FPR)与中晚期非小细胞肺癌(NSCLC)临床病理特征及预后的关系。方法收集2014年12月至2017年12月360例中晚期NSCLC患者的临床资料,计算FPR,进行受试者工作特征(ROC)曲线分析,采用χ~2检验分析其与NSCLC临床病理特征的关系,生存分析用Kaplan-Meier法并行Log-rank检验,预后分析用Cox多因素回归模型。结果 ROC曲线显示,FPR、FIB、PA和中性粒细胞-淋巴结胞比值(NLR)评估NSCLC的预后效果较好(P<0.05)。FPR水平与年龄、临床分期、T分期和远处转移有关(P<0.05)。高FPR组151例患者的中位总生存时间(OS)为9个月,低于低FPR组209例患者的17个月(P<0.05)。单因素分析显示,临床分期、T分期、N分期、远处转移、病理类型、行姑息性手术或放疗、FPR、NLR、FIB、PA与中晚期NSCLC患者的OS有关(P<0.05);Cox多因素分析显示,临床分期、T分期、N分期、远处转移、行姑息性手术或放疗、FPR和NLR是影响中晚期NSCLC患者OS的独立因素(P<0.05)。结论 FPR是影响中晚期NSCLC患者OS的独立因素,FPR升高提示预后不良。

Objective To investigate the correlation between fibrinogen(FIB)?to?prealbumin(PA)ratio(FPR)and clin?icopathologic characteristics and prognosis of patients with non?small cell lung cancer(NSCLC).Methods The clinical and labora?tory data of 360 patients with advanced NSCLC from December 2014 to December 2017 were collected,and FPR was calculated.Re?ceiver operating characteristic(ROC)curve was analyzed.Chi?square test was used to analyze the relationship between FPR and the clinicopathologic characteristics.Survival analysis was performed by Kaplan?Meier method and Log?rank test.Cox regression model was used for multivariate analysis.Results ROC analysis showed that FPR,FIB,PA and neutrophil?to?lymphocyte ratio(NLR)were effective in evaluating the prognosis of NSCLC(P<0??05).Chi?square test showed that the level of FPR was correlated with age,clinical stage,T stage and distant metastasis(P<0??05).The median overall survival(OS)of 151 patients in high FPR group was 9 months,lower than 17 months of 209 patients in low FPR group(P<0??05).Univariate survival analysis indicated that clinical stage,T stage,N stage,distant metastasis,pathological types,palliative surgery or radiotherapy,FPR,NLR,FIB and PA were the factors influencing the OS of patients(P<0??05).Cox multivariate survival analysis showed that clinical stage,T stage,N stage,dis?tant metastasis,palliative surgery or radiotherapy,FPR and NLR were independent factors influencing OS of patients with advanced NSCLC(P<0??05).Conclusion FPR is an independent prognostic factor for patients with advanced NSCLC,and high FPR is as?sociated with poor prognosis.