术前纤维蛋白原联合血小板与淋巴细胞比值对膀胱癌根治术后患者的预后预测价值

Prognostive Value of Preoperative Fibrinogen Combined with Platelet-lymphocyte Ratio on Prognosis of Patients Undergoing Radical Cystectomy

目的探讨术前纤维蛋白原(FIB)联合血小板与淋巴细胞比值(PLR)对膀胱癌根治术(RC)后患者预后的预测价值。方法纳入141例行根治性切除术后的尿路上皮膀胱癌患者。ROC曲线确定FIB和PLR的cut-off值。将FIB、PLR分成高水平组和低水平组,二者均为低水平定义为组合评分0(S0),余均定义为组合评分1(S1)。单因素方差和非参数检验分析患者临床特征,Kaplan-Meier法行单因素生存分析,Log rank法进行检验,Cox比例风险模型进行多因素回归分析。结果FIB和PLR最佳截断值分别为3.43和110.54。FIB水平与T分期、病理分级及肿瘤大小密切相关(均P<0.05),PLR水平与病理分级及肿瘤大小密切相关(P<0.05)。术前组合评分与T分期、N分期、病理分级及肿瘤大小密切相关(均P<0.05)。组合评分、T分期、肿瘤大小、FIB及PLR是影响预后的重要因素。组合评分(P=0.019)、T分期(P=0.021)及FIB(P=0.010)是影响膀胱癌患者预后的独立危险因素。结论组合评分是影响膀胱癌根治术后患者总生存期的独立危险因素,可作为预测膀胱癌患者肿瘤进展及预后的新指标。

Objective To investigate the prognostive value of preoperative fibrinogen(FIB)combined with platelet-lymphocyte ratio(PLR)on the prognosis of patients undergoing radical cystectomy(RC).Methods We enrolled 141 patients with urothelial carcinoma after radical cystectomy.ROC curve was used to determine the optimal cutoff values of FIB and PLR.The FIB and PLR were divided into the high-level group and the low-level group.If one indicator was high-level or both indicators were high-level,a combination score 1(S1)was defined.If both indicators were low-level,a combination score 0(S0)was defined.One-way analysis of variance and non-parametric tests were used to analyze the characteristics of patients,the Kaplan-Meier method was used for univariate survival analysis,the Log rank method was used for testing,and the Cox proportional hazards model was used for multivariate regression analysis.Results The optimal cutoff values for FIB and PLR were 3.43 and 110.54,respectively.FIB level was closely related to T stage,pathological grade and tumor size(all P<0.05),and PLR level was closely related to pathological grade and tumor size(P<0.05).The preoperative combination score was closely related to T stage,N stage,pathological grade and tumor size(all P<0.05).Combination score,T stage,tumor size,FIB and PLR were important factors affecting the prognosis.Combination score(P=0.019),T stage(P=0.021)and FIB(P=0.010)were independent risk factors for the prognosis.Conclusion The combination score is an independent risk factor for overall survival of patients undergoing radical cystectomy.It can be used as a new indicator for predicting the tumor progression and prognosis of patients with bladder cancer.