FAR联合NLR对可切除胰头癌患者预后的价值

Prognostic Value of FAR Combined with NLR in Patients with Resectable Pancreatic Head Cancer

目的研究术前纤维蛋白原与白蛋白比值(FAR)联合中性粒细胞与淋巴细胞比值(NLR)对可切除胰头癌患者的预后价值。方法以2014年3月~2020年9月于徐州医科大学附属医院接受胰头癌根治术的99例患者为胰头癌组,胰腺良性病变患者78例为胰腺良性病变组,同期健康体检者80例为正常对照组。收集3组临床资料,计算血清FAR、NLR,行3组间FAR、NLR水平比较。根据受试者工作特征曲线(ROC)结果,计算胰头癌组最佳截断值,FAR、NLR的最佳截断值分别为0.09、3.10,FAR≥0.09、NLR≥3.10赋予1分,FAR<0.09、NLR<3.10赋予0分,上述两项指标评分相加后分值为0、1、2共3组。比较3组间患者临床病理资料及术后总体中位生存时间的差异。结果胰头癌组患者血清FAR及NLR均明显高于胰腺良性病变组,胰腺良性病变组的FAR、NLR明显高于正常对照组。胰头癌组临床特征分析显示FAR-NLR与腹腔感染、胰瘘相关(P<0.05)。COX单因素结果显示,肿瘤直径、分化程度、胰瘘、FAR-NLR是胰头癌患者预后不良的危险因素(P<0.05),多因素分析显示FAR-NLR、肿瘤直径、分化程度是胰头癌患者预后的独立危险因素(P<0.05)。结论FAR-NLR是可切除胰头癌患者预后的独立危险因素,FAR-NLR的预测性能优于其单一指标,有助于术前评估胰头癌患者的预后。

Objective To investigate the prognostic value of preoperative fibrinogen to albumin ratio(FAR)combined with neutrophil to lymphocyte ratio(NLR)in patients with resectable pancreatic head cancer.Methods Ninety-nine patients who underwent radical pancreatic head cancer surgery at the Affiliated Hospital of Xuzhou Medical University from March 2014 to September 2020 were used as the pancreatic head cancer group,78 patients with benign pancreatic lesions were used as the benign pancreatic lesions group,and 80 patients with healthy physical examination during the same period were used as the normal control group.The clinical data of the three groups were collected,serum FAR and NLR were calculated,and the levels of FAR and NLR were compared between the three groups.The optimal cut-off values for FAR and NLR were 0.09 and 3.10 respectively,and a score of 1 was assigned to FAR≥0.09 and NLR≥3.10,while a score of 0 was assigned to FAR<0.09 and NLR<3.10.The scores of the above 2 indexes were summed to 0,1 and 2 for the 3 groups.The differences in clinicopathological data and overall median survival time after surgery were compared between the 3 groups.Results Serum FAR and NLR were significantly higher in the pancreatic head cancer group than in the benign pancreatic lesion group,and FAR and NLR were significantly higher in the benign pancreatic lesion group than in the normal control group.The analysis of clinical characteristics in the pancreatic head cancer group showed that FAR-NLR was associated with abdominal infection and pancreatic fistula(P<0.05).The COX univariate results showed that tumour size,degree of differentiation,pancreatic fistula and FAR-NLR were risk factors for poor prognosis in patients with pancreatic head cancer(P<0.05),and the multifactorial analysis showed that FAR-NLR,tumour size and degree of differentiation were independent risk(P<0.05).Conclusion FAR-NLR is an independent risk factor for the prognosis of patients with resectable pancreatic head cancer,and the predictive performance of FAR-NLR is better than its single indicator to help assess the prognosis of patients with pancreatic head cancer preoperatively.