血小板与淋巴细胞比值对前列腺癌预后的临床价值

CLINICAL VALUE OF PLATELET/LYMPHOCYTE RATIO IN THE PROGNOSIS OF PROSTATE CANCER

目的探讨血小板与淋巴细胞比值(PLR)对前列腺癌预后的价值。方法回顾性分析2012年9月—2015年12月于青岛大学附属医院首次确诊的312例前列腺癌病人的临床资料。根据术前外周静脉血检查结果计算PLR,将病人分为高PLR组(PLR≥146.9)和低PLR组(PLR<146.9),比较两组病人的临床病理参数,使用Kaplan-Meier生存曲线分析PLR对前列腺癌病人预后的影响,采用Cox比例风险模型分析前列腺癌病人的预后影响因素。结果与低PLR组相比,高PLR组病人年龄大、危险度高、前列腺特异抗原水平高、肿瘤侵犯范围大、Gleason评分高、肿瘤分期晚( χ^(2)=13.223~60.308,t=2.146、2.943,P<0.05)。Kaplan-Meier生存曲线分析显示,低PLR组病人总生存率明显高于高PLR组( χ^(2)=23.083,P<0.05)。多因素Cox回归分析显示,PLR是前列腺癌病人的独立预后因素(HR=1.008,95%CI=1.001~1.014,P<0.05)。结论术前外周血PLR越高,前列腺癌恶性程度越高,预后越差。

Objective To investigate the clinical value of platelet/lymphocyte ratio(PLR)in the prognosis of prostate cancer.Methods A retrospective analysis was performed for the clinical data of 312 patients with prostate cancer who were first diagnosed in Affiliated Hospital of Qingdao University from September 2012 to December 2015.The PLR value was calculated according to the preoperative peripheral venous blood test results,and the patients were divided into high PLR group(PLR≥146.9)and low PLR group(PLR<146.9).The clinicopathological parameters were compared between the two groups,the Kaplan-Meier survival curve was used to analyze the prognostic effect of PLR on prostate cancer patients,and the Cox proportional hazards model was used to analyze the prognostic factors of prostate cancer patients.Results Compared with the low PLR group,the high PLR group had older age,higher risk,higher prostate-specific antigen level,larger tumor invasion extent,higher Gleason score,and more advanced tumor stage( χ^(2)=13.223-60.308;t=2.146,2.943;P<0.05).The Kaplan-Meier curve analysis showed that the overall survival rate of patients in the low PLR group was significantly higher than that in the high PLR group( χ^(2)=23.083,P<0.05).The multivariate Cox regression analysis showed that PLR was an independent prognostic factor for prostate cancer patients(HR=1.008,95%CI=1.001-1.014,P<0.05).Conclusion A higher preoperative PLR in peripheral blood is associated with higher malignancy of prostate cancer and worse prognosis.