外周血炎性指标PLR和LMR与胆道系统恶性肿瘤患者预后的关系

The Relationship between PLR and LMR in Peripheral Blood and Prognosis of Patients with the Biliary Tract Cancer

目的:探讨治疗前外周血炎性指标血小板/淋巴细胞比值(PLR)、淋巴细胞/单核细胞比值(LMR)与胆道系统恶性肿瘤(BTC)患者预后的关系。方法:检索电子病历系统,回顾性收集2013年6月—2018年8月广西壮族自治区人民医院收治的100例病理确诊的BTC患者的临床资料及随访数据。根据文献资料,将患者分为低PLR组(PLR≤150)和高PLR组(PLR>150);以及低LMR组(LMR≤3)和高LMR组(LMR>3)。采用χ2检验或Fisher精确概率法检验比较两组临床特征。采用Cox风险回归模型分析影响BTC患者预后的独立危险因素。结果:本研究纳入100例BTC患者,低PLR组与高PLR组在TNM分期方面差异有统计学意义(P<0.05)。低LMR组与高LMR组在功能状态(Performance Status,PS)评分方面差异有统计学意义(P<0.05)。Cox回归模型单因素分析显示,PLR、单核细胞计数、PS评分是影响BTC患者预后的因素(P<0.05)。而LMR不是影响胆道系统恶性肿瘤预后的因素(P>0.05)。Cox回归模型多因素分析显示,PLR、单核细胞计数、PS评分是影响BTC患者预后的独立危险因素(P<0.05)。结论:PLR、单核细胞计数、PS评分可以作为BTC患者的预后因素,高PLR、单核细胞计数升高、高PS评分提示患者预后不良。目前资料未显示LMR水平与BTC患者预后相关。

Objective:To explore the relationship between platelet to lymphocyte ratio(PLR),lymphocyte to monocyte ratio(LMR)and prognosis of patients with the biliary tract cancer(BTC)before treatment.Methods:Retrieve the electronic medical record system and retrospectively collect the clinical data and follow-up data of 100 patients with pathologically confirmed BTC admitted to the people’s hospital of Guangxi Zhuang Autonomous Region from June 2013 to August 2018.According to the records,patients were divided into a low PLR group(PLR≤150)and a high PLR group(PLR>150),a low LMR group(LMR≤3)and a high LMR group(LMR>3).The clinical characteristics between the two groups were compared by using chi-square test or Fisher’s exact test as appropriate.The COX regression model was used to identify the independent risk factors affecting the prognosis of BTC patients.Results:This study included 100 patients with BTC.There were significant differences in TNM staging between low PLR group and high PLR group(P<0.05).There were significant differences in performance status(PS)scores between low LMR group and high LMR group(P<0.05).Univariate analysis of Cox regression model showed that PLR,monocyte count and PS score were the factors influencing the prognosis of BTC patients(P<0.05).LMR was not a prognostic factor for malignant tumors of biliary system(P>0.05).Multivariate analysis of Cox regression model showed that PLR,monocyte count and PS score were independent prognostic risk factors for the prognosis of BTC patients(P<0.05).Conclusion:PLR,monocyte count and PS score can serve as prognostic factors in BTC patients.BTC patients with High PLR,high monocyte count and high PS score predict a worse prognosis.Our data indicate that LMR level is of no statistical significance to prognosis.