术前血清乳酸脱氢酶与白蛋白比值对脑胶质瘤患者预后影响的研究

Effect of Preoperative Serum Lactate Dehydrogenase-to-albumin Ratio on the prognosis of Patients with Glioma

目的探讨术前血清乳酸脱氢酶(lactate dehydrogenase,LDH)与白蛋白(albumin,ALB)比值(lactate dehydrogenase to albumin ratio,LAR)对脑胶质瘤患者预后的影响。方法回顾性分析101例胶质瘤患者的临床资料;采用受试者工作特征(receiver operating characteristics,ROC)曲线分析LAR最佳临界值,分为高LAR组与低LAR组;采用Kaplan-Meier法绘制生存曲线;纳入性别、年龄、KPS评分、肿瘤直径、肿瘤病理分级、肿瘤切除程度、术后放疗、术后化疗和LAR因素进行统计学分析。采用COX单因素及多因素分析研究LAR与胶质瘤无进展生存期(progress free survival,PFS)和总生存期(overall survival,OS)之间的相关性,评估术前LAR对脑胶质瘤患者预后的临床价值。结果高LAR组的PFS和OS均短于低LAR组(P<0.05)。COX单因素分析显示,肿瘤病理级别、切除程度、放疗、化疗、术前LAR水平是影响胶质瘤患者PFS和OS的危险因素(P<0.05)。多因素回归模型结果显示,高级别胶质瘤、肿瘤全切、放疗、化疗、LAR≥4.043是影响胶质瘤患者PFS和OS的独立危险因素(P<0.05)。结论胶质瘤患者术前血清LAR水平可作为评估胶质瘤患者预后的独立危险因素,LAR≥4.043提示胶质瘤患者预后不良。

Objective To explore the effect of preoperative serum lactate dehydrogenase-to-albumin ratio(LAR)in evaluating the prognosis of patients with glioma.Methods We retrospectively analyzed the clinical data of 101 patients with glioma.Receiver operating characteristic(ROC)curve was applied to analyze the optimal cutoff value of LAR,which was used to divide patients into high and low LAR groups.Kaplan-Meier method was used to draw the survival curve.Gender,age,KPS score,tumor diameter,tumor pathological grade,tumor resection degree,postoperative radiotherapy,postoperative chemotherapy and LAR were included for statistical analysis.Univariate and multivariate COX regression analyses were utilized to analyze the correlation between LAR and progress free survival(PFS)or overall survival(OS),and evaluate the clinical value of preoperative LAR for the prognosis of patients with glioma.Results The PFS and OS of the high LAR group were shorter than those of the low LAR group(P<0.05).Univariate analysis showed that pathological grade,resection degree,radiotherapy,chemotherapy and preoperative LAR were risk factors for PFS and OS of glioma(P<0.05).Multivariate analysis showed that high-grade glioma,resection degree,radiotherapy,chemotherapy and LAR≥4.043 were independent risk factors for PFS and OS of glioma(P<0.05).Conclusion Preoperative serum LAR level was an independent risk factor in patients with glioma,and LAR≥4.043 predicted poor prognosis.