血小板分布宽度预测肺腺癌根治性切除术患者预后的临床价值

Clinical Value of Platelet Distribution Width in Predicting the Prognosis of Patients with Radical Resection of Lung Adenocarcinoma

【目的】探讨血小板分布宽度(PDW)预测肺腺癌根治性切除术患者预后的临床价值。【方法】测定两院收治的186例行肺腺癌根治切除术治疗的患者的PDW,根据受试者工作特征(ROC)曲线确定PDW临界值,将患者分为高PDW组与低PDW组。分析PDW与肺腺癌患者临床特征的关系。出院后连续随访3年,采用多因素Cox回归分析肺腺癌患者预后的影响因素。【结果】PDW最佳截断值为2.57时预测价值最高。TNM分期为Ⅱ~Ⅲ期、肿瘤直径>3 cm患者的PDW高表达率高于TNM分期为Ⅰ期、肿瘤直径≤3 cm的患者(P<0.05)。随访3年,186例患者中119例存活,总生存率为63.98%(119/186);患者3年总生存率与TNM分期、肿瘤直径、PDW有关(均P<0.05);低PDW组患者的3年总生存率为79.00%(79/100),高于高PDW组的46.51%(40/86)(P<0.05)。多因素Cox回归分析显示:TNM分期为Ⅱ~Ⅲ期、肿瘤直径≥3 cm、PDW≥2.57是患者预后不良的危险因素(P<0.05)。【结论】PDW与肺腺癌根治性切除术患者预后密切相关,其对患者预后的评估具有较高的预测价值,PDW、TNM分期、肿瘤直径均为影响肺腺癌患者预后的独立危险因素。

【Objective】To explore the clinical value of platelet distribution width(PDW)in predicting the prognosis of patients with radical resection of lung adenocarcinoma.【Methods】The PDW levels of 186 patients undergoing radical resection of lung adenocarcinoma admitted to two hospitals were measured.The critical value of PDW was determined based on the receiver operating characteristic(ROC)curve of the subjects,and the patients were divided into high PDW group and low PDW group.The relationship between PDW levels and clinical characteristics of cancer patients was analyzed.After discharge,continuous follow-up for 3 years was conducted to explore the influencing factors of patient prognosis using multivariate Cox regression analysis.【Results】The optimal cutoff value for PDW was 2.57,which had the highest predictive value.The high expression rate of PDW in patients with TNM stageⅡ-Ⅲand tumor diameter>3 cm was higher than that in patients with TNM stage I and tumor diameter≤3 cm(P<0.05).After a 3-year follow-up,119 out of 186 patients survived,with an overall survival rate of 63.98%(119/186);The 3-year overall survival rate of patients was related to TNM staging,tumor diameter,and PDW(mean P<0.05);The 3-year overall survival rate of patients in the low PDW group was 79.00%(79/100),which was higher than the 46.51%(40/86)in the high PDW group(P<0.05).Multivariate Cox regression analysis showed that TNM stageⅡ-Ⅲ,tumor diameter≥3 cm,and PDW≥2.57 were risk factors for poor prognosis in patients(P<0.05).【Conclusion】The level of PDW is closely related to the prognosis of patients with radical resection of lung adenocarcinoma,and it also has high predictive value for prognosis evaluation.PDW,TNM staging,and tumor diameter are independent risk factors affecting patient prognosis.