术前APRI、GPRI和LMR与远端胆管癌术后远期生存的相关性分析

Correlation Analysis Between Preoperative APRI,GPRI and LMR and Long-term Survival After Distal Cholangiocarcinoma Surgery

目的探讨术前天冬氨酸氨基转移酶/血小板比值(aspartate aminotransferase-to-plateletratio index,APRI)、γ-谷氨酰转肽酶/血小板比值(γglutamyl transpeptidase platelet ratio index,GPRI)和淋巴细胞/单核细胞比值(lymphocyte monocyte ratio,LMR)与远端胆管癌术后远期生存的相关性分析。方法回顾性分析胆管癌患者86例,采用单因素、多因素分析方法采用Cox比例风险回归模型。结果术前APRI、GPRI和LMR水平与远端胆管癌术后远期生存有关,经随访可知,术前APRI≤0.50的6个月、1年、2年生存率分别为78.00%、69.00%、37.00%,术前APRI>0.50的6个月、1年、2年生存率分别为52.00%、42.00%、16.00%;术前GPRI≤0.25的6个月、1年、2年生存率分别为86.00%、72.00%、53.00%,术前GPRI>0.25的6个月、1年、2年生存率分别为64.00%、49.00%、20.00%;术前LMR≤2.07的6个月、1年、2年生存率分别为87.00%、71.00%、35.00%,术前LMR>2.07的6个月、1年、2年生存率分别为69.00%、54.00%、32.00%。COX函数模型结果表明,术前APRI(HR:3.774,P<0.001),术前GPRI(HR:4.081,P<0.001),术前LMR(HR:3.520,P<0.001)是影响远端胆管癌术后远期生存危险因素。结论术前APRI水平、GPRI水平和LMR水平是远端胆管癌术后远期生存的独立危险因素,随着年限的增长,生存率逐渐下降,对于评估其术后远期生存时间有一定的作用,具有一定的相关性。这些血清指标数值可靠,采取便捷、创伤小,利于临床使用,值得推广。

Objective To investigate the correlation between preoperative aspartate aminotransferase-to-platelet ratio index(APRI),γ-glutamyl transpeptidase/platelet ratio index(GPRI)and lymphocyte/monocyte ratio(LMR)and long-term survival after distal cholangiocarcinoma surgery.Methods A retrospective analysis of 86 patients with cholangiocarcinoma was carried out.Univariate and multivariate analysis were used and Cox proportional hazards regression model was used.Results Preoperative APRI,GPRI and LMR were related to the long-term survival of distal cholangiocarcinoma after operation.After follow-up,the 6 months,1 year,2 years survival rates were 78.00%,69.00%and 37.00%for preoperative APRI≤0.50,52.00%,42.00%and 16.00%for preoperative APRI>0.50,86.00%,72.00%and 53.00%for preoperative GPRI≤0.25,64.00%,49.00%and 20.00%for preoperative GPRI>0.25,and 87.00%,71.00%and 35.00%for preoperative LMR≤2.07%,and 69.00%,54.00%,and 32.00%for preoperative LMR>2.07.The results of Cox function model showed that preoperative APRI(HR:3.774,P<0.001),preoperative GPRI(HR:4.081,P<0.001),and preoperative LMR(HR:3.520,P<0.001)were risk factors for long-term survival after distal cholangiocarcinoma surgery.Conclusion Preoperative APRI level,GPRI level and LMR level are independent risk factors for long-term survival after distal cholangiocarcinoma surgery.As the age grows,the survival rate gradually decreases,which plays a role in evaluating the long-term survival time after surgery and has a certain correlation.These serum index values are reliable,convenient,minimally invasive,and conducive to clinical use,which is worthy of promotion.