纤维蛋白原与血小板/淋巴细胞计数比值评分系统在肝癌根治性肝切除术后生存评估中的应用价值

the prognostic value of preoperative plasma fbrinogen level and platelet-to-lymphocyte ratio(F-PLR)in hepatocellular carcinoma patients after radical hepatectomy

目的探讨纤维蛋白原与血小板/淋巴细胞比值(F-PLR)评分在评估行肝细胞癌患者的根治切除术后预后的价值。方法回顾性分析2007年至2014年间安徽省省立医院肝脏外科行根治性肝切除的肝癌患者150例,收集临床病理资料,利用ROC曲线确定纤维蛋白原及PLR的最佳截点分别为2.915和100.35,按照以下标准分组:两项均高于各自最佳截点值分值为2分,两项中只有一项高于最佳截点值的分值为1,两项均低于最佳截点值为0分。采用Kapkn-Meier法进行单因素分析计算生存率,并采用Log-rank检验进行生存分析。采用COX模型进行多因素生存分析。结果单因素分析示高F-PLR评分的HCC患者具有更差的术后总生存率及无瘤生存率,F-PLR评分为0、1、2的总生存中位时间为65、27、14(月),中位无瘤生存时间为47、21、13(月),亚组间比较差异均具有统计学意义(P<0.001)。多因素分析示F-PLR、PLR及纤维蛋白原为影响HCC患者术后总生存率的独立危险因素,F-PLR、PLR及肿瘤包膜为影响HCC患者术后无瘤生存率的独立危险因素。结论F-PLR可作为肝癌患者根治性肝切除术后的预后预测指标。

Objective to explore the prognostic value of preoperative plasma fbrinogen level and platelet-to-lymphocyte ratio(F-PLR)in hepatocellular carcinoma patients after radical hepatectomy.Method the method of retrospective case-control study was performed.The clinicopathological data of 150 HCC patients who radical liver resection at hepatic surgery department,Anhui provincial hospital from 2006 to 2014 were collected.The optimal cut-off value of fibrinogen and PLR was determined using Receiver-operating characteristic(ROC)approach for 0S(2.915 and 100.35).Patients were divided into groups according to F-PLR score as following criteria:patients with both elevated fibrinogen and PLR were assigned a score of 2,and patients with either or neither were assigned a scored of 1 or 0,respectively.Overall survival(OS)and recurrence-free survival(RFS)were calculated with the Kaplan-Meier method and compared by the log-rank test.Cox proportional hazard model was used to evaluate the prognostic factors.Result Kaplan-Meier curve with univariate analysis(log-rank)showed that OS time of the patients who had a high F-PLR score was shorter than who had a low score,similarly,compared with the patients with low score,the patients who had a high F-PLR score had a shorter RFS time.The median OS time of HCC patients whose F-PLR score 0,1,2 were 65、27、14 respectively,and The median RFS time of HCC patients whose F-PLR score 0,1,2 were 47、21、13 respectively,the results of multivariate analysis showed that F-PLR,PLR,fbrinogen level were independent risk factor for OS of HCC patients who accepted radical hepatectomy,and F-PLR,PLR,tumor capsule were the independent risk factor for RFS.Conclusion F-PLR was the predictive factor for HCC patients who accepted radical hepatectomy.