PLR对于胰腺癌手术患者预后的相关性研究

Prognostic Significance of PLR in Patients with Pancreatic Cancer

摘要: 目的：全身炎症标志物与包括胰腺癌(Pancreatic Cancer)在内的各种癌症患者的生存率相关。本研究的目的是探讨血小板、淋巴细胞数比值(PLR)对胰腺癌手术患者的预测价值。方法：回顾性分析2013年8月至2019年12月在青岛大学附属医院住院并于2020年12月随访的胰腺癌手术患者。收集临床资料和实验室检查指标，计算PLR值，并使用Youden指数确定最佳截止值。Kaplan-Meier绘制生存曲线，曲线之间的差异通过Log-Rank检验进行分析。采用Cox比例风险模型，通过单因素与多因素分析评价PLR对于胰腺癌手术患者预后的预测价值。结果：共有214名患者(中位年龄60.29岁；128名[59.8%]男性)符合纳入标准。根据约登指数，将患者分为高PLR组和低PLR组，最佳截止值为127。通过Cox比例风险回归模型对患者生存期及无病生存期进行单因素及多因素分析，多因素分析结果示，PLR与总生存期无明显相关性(HR, 1.093; 95% CI 0.411~2.905; P = 0.858)；而在无病生存期的多因素分析中，PLR (HR, 0.535; 95% CI 0.306~0.935; P = 0.028)是独立危险因素。Cox比例风险模型确定了高水平的PLR (>127)是无病生存期负相关的独立因素。结论：高水平的PLR是手术切除胰腺癌患者无病生存期短的独立危险因素。

Abstract: Objectives: Systemic inflammatory markers are associated with the survival rate of patients with various cancers including Pancreatic Cancer. The purpose of this study was to investigate the predictive value of platelet and lymphocyte ratio (PLR) in patients with pancreatic cancer. Methods: A retrospective analysis was performed on patients with pancreatic cancer who were hospitalized in the Affiliated Hospital of Qingdao University from August 2013 to December 2019 and were followed up in December 2020. Collect clinical data and laboratory examination indexes, calculate PLR value, and use Youden index to determine the best cut-off value. Kaplan Meier plotted survival curves, and the differences between the curves were analyzed by log rank test. Cox proportional-hazard model was used to analyze the prognostic value of PLR in pancreatic cancer patients by univariate and multivariate analysis. Results: A total of 214 patients (median age 60.29 years; 128 [59.8%] men) met the inclusion criteria. According to the Yoden index, the patients were divided into high PLR group and low PLR group, and the best cut-off value was 127. The overall survival and disease-free survival time were analyzed by Cox proportional-hazard model. The results of multivariate analysis showed that there was no significant correlation between PLR and overall survival time (HR, 1.093; 95% CI, 0.411~2.905; P = 0.858); in multivariate analysis of disease-free survival, PLR (HR, 0.535; 95% CI, 0.306~0.935; P = 0.028) was an independent risk factor. The Cox proportional hazards model identified a high level of PLR (>127) as an independent factor negatively associated with disease-free survival. Conclusion: High level of PLR is an independent risk factor for a short period of disease-free survival in patients with pancreatic cancer.