胆道系统恶性肿瘤患者临床特征资料与生存的相关性分析

Relationship between clinical characteristics and survival of patients with the biliary tract cancer

目的:分析胆道系统恶性肿瘤(BTC)患者临床特征资料与生存的相关性。方法:回顾性收集广西壮族自治区人民医院收治的100例病理确诊的BTC患者的临床特征资料,临床特征资料包括性别、年龄、入院后次日血常规数据得出的外周血炎性指标血小板/淋巴细胞比值(PLR)和淋巴细胞/单核细胞比值(LMR)、有无胆结石和胆道系统慢性炎症病史、原发灶部位、功能状态(PS)评分、TNM分期、治疗前糖类抗原19-9(CA19-9)水平、有无抗肿瘤治疗。随访所有患者的总生存期(OS)。采用寿命表法计算生存率,采用Kaplan-Meier法比较各项临床特征中组间患者的生存率,并绘制患者的生存曲线。结果:100例病理确诊BTC患者的中位生存时间为9.7个月,1年、2年、3年、4年生存率分别为18%、12%、9%和3%。PS评分1~2分组与3~4分组生存率比较、TNM分期Ⅰ~Ⅱ期组与Ⅲ~Ⅳ期组生存率比较、有无抗肿瘤治疗之间生存率比较,差异均有统计学意义(P<0.05)。PLR<150组与PLR≥150组之间的生存率比较,LMR<3组与LMR≥3组之间的生存率比较,差异均无统计学意义(P>0.05)。此外,性别、有无胆结石和胆道系统慢性炎性反应、原发灶部位不同、治疗前CA19-9水平是否正常之间的生存率比较,差异均无统计学意义(P>0.05)。结论:PS评分3~4分、TNM分期Ⅲ~Ⅳ期、未进行抗肿瘤治疗的BTC患者生存率较低,临床可将此三项指标作为判断BTC患者预后的重要指标。

Objective To explore the relationship between clinical characteristics and survival of patients with the biliary tract cancer(BTC).Method Retrospectively collect the clinical data of 100 patients with pathologically confirmed BTC admitted to Guangxi Zhuang Autonomous Region People's Hospital.Clinical characteristics included sex,age,platelet to lymphocyte ratio(PLR)and lymphocyte to monocyte ratio(LMR),chronic inflammation history of gallstones and biliary tract system,primary lesion,performance status(PS)scores,TNM stage,and level of carbohydrate antigens 19-9(CA19-9)before treatment and anti-cancer therapy.Overall survival(OS)was followed up in all patients.The survival rate was calculated by life table method,and the survival rate of patients between groups was compared by Kaplan-Meier method,and the survival curve of patients was drawn.Results The median survival time of 100 patients with pathologically confirmed BTC was 9.7 months.The One-year survival rate was 18%.The 2-year survival rate was 12%.The 3-year survival rate was 9%.The 4-year survival rate was 3%.The survival rates of PS score 1~2 group and 3~4 group were significantly different(P<0.05).The survival rates of TNM stageⅠ~Ⅱgroup and stageⅢ~Ⅳgroup were significantly different(P<0.05).The survival rates of anti-cancer therapy group and non-anticancer treatment group were significantly different(P<0.05).The survival rates between PLR≥150 group and PLR<150 group were not significantly different(P>0.05).The survival rates between LMR≥3 group and LMR<3 group were not significantly different(P>0.05).In addition,the survival rates of sex,chronic inflammation of gallstones and biliary tract system,different locations of primary lesion and different level of CA19-9 before treatment were not significantly different(P>0.05).Conclusion The survival rate of BTC patients with PS score 3~4,TNM stageⅢ~Ⅳand without antineoplastic therapy is lower.These three indicators can be used as important prognostic indicators in clinic.