术前外周血实验室指标在卵巢上皮性癌患者预后预测中的应用

Application of preoperative peripheral blood laboratory indicators in prognostic prediction of patients with epithelial ovarian cancer

目的 探讨术前外周血实验室指标在卵巢上皮性癌患者预后预测中的应用价值。方法 回顾性纳入2013年1月至2017年1月于北京市顺义区妇幼保健院诊治卵巢上皮性癌患者共123例,分析临床病理资料及随访生存情况,采用单因素和多因素法评价卵巢上皮性癌患者总生存时间独立影响因素,描绘受试者工作特征(ROC)曲线评价相关独立影响因素联合用于预后预测临床效能。结果 单因素分析结果显示,年龄、国际妇产科联盟(FIGO)分期、糖类抗原(CA)125水平、平均血小板体积(MPV)/血小板计数(PLT)、中性粒细胞计数与淋巴细胞比值(NLR)、单核细胞与淋巴细胞比值(MLR)及纤维蛋白原水平均与卵巢上皮性癌患者总生存时间有关(P <0.05);多因素分析结果显示,年龄> 60岁、FIGO分期Ⅲ~Ⅳ期、MPV/PLT>0.04、MLR>0.27及纤维蛋白原<3.30 g/L均是卵巢上皮性癌患者短总生存时间的独立危险因素(P <0.05);ROC曲线分析结果显示,MPV/PLT、MLR及纤维蛋白原均可用于上皮性卵巢癌患者预后预测,且三者联用预测效能最佳(P <0.05)。结论 上皮性卵巢癌患者预后与包括年龄、FIGO分期、MPV/PLT、MLR及纤维蛋白原水平在内多种因素有关,同时MPV/PLT、MLR及纤维蛋白原联合检测具有更佳的预后预测价值。

Objective To investigate the application value of preoperative peripheral blood laboratory indicators in prognostic prediction of patients with epithelial ovarian cancer.Methods 123 patients with epithelial ovarian cancer were retrospectively chosen in the period from January 2013 to January 2017.The clinicopathological data and follow-up survival were analyzed.Univariate and multivariate methods were used to evaluate the independent factors influencing the total survival time of patients with ovarian epithelial cancer,and receiver operating characteristic(ROC) curve was described to evaluate the clinical efficacy of the combined independent factors for prognostic prediction.Results Univariate analysis showed that age,the international union of gynecology and obstetrics(FIGO) staging,level of carbohydrate antigen 125(CA125),mean platelet volume(MPV) and platelet count(PLT),neutrophil counts and lymphocyte ratio(NLR),monocyte and lymphocyte ratio(MLR) provision and fibrin raw water average associated with overall survival time of patients with ovarian epithelial carcinoma(P<0.05).Multivariate analysis showed that age>60years,FIGO stage Ⅲ-Ⅳ,MPV/PLT>0.04,MLR>0.27 and fibrinogen <3.30 g/L were all independent risk factors for short overall survival in patients with epithelial ovarian cancer(P<0.05).The results of ROC curve analysis showed that MPV/PLT,MLR and fibrinogen could all be used to predict the prognosis of epithelial ovarian cancer patients,and the combination of three above had the best prediction efficacy(P<0.05).Conclusions The clinical prognosis of epithelial ovarian cancer patients is correlated with multiple factors including age,FIGO stage,MPV/PLT,MLR and fibrinogen level.The combined detection of MPV/PLT,MLR and fibrinogen has better prognostic value.