Negative impact of preoperative platelet-lymphocyte ratio on outcome after hepatic resection for intrahepatic cholangiocarcinoma.
Negative impact of preoperative platelet-lymphocyte ratio on outcome after hepatic resection for intrahepatic cholangiocarcinoma.
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术前血小板-淋巴细胞比率对肝内胆管癌肝切除术后预后的负面影响。
DOI：
10.1097/md.0000000000000574
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发表时间：
2015-04
期刊：
影响因子：
1.6
通讯作者：
Zhou J
中科院分区：
文献类型：
--
作者：
Chen Q;Dai Z;Yin D;Yang LX;Wang Z;Xiao YS;Fan J;Zhou J
据报道，血小板与淋巴细胞比率(PLR)的升高是几种癌症患者生存不良的一个预测因素。PLR是一种基于血小板和淋巴细胞计数的简易血液测试方法。到目前为止，对肝内胆管细胞癌(ICC)患者术前PLR的预后作用的研究还很少。我们研究的目的是评估PLR在肝切除后大量ICC患者中的预后意义。我们获得了2005-2011年间连续322名非转移性ICC患者的数据，这些患者在没有进行术前治疗的情况下接受了肝切除术。评估包括PLR在内的临床病理参数。采用Kaplan-Meier方法评估总生存率(OS)和无复发生存率(RFS)。运用多因素COX回归模型，确定术前PLR的独立预后价值。通过单变量和多变量分析，我们的结果显示PLR是ICC患者OS和RFS的一个独立的不良预后因素。通过对接收机工作曲线的分析，得出最佳的PLR截止值为123。术后5年生存率分别为30.3%和28.9%，低于123组的46.2%和39.4%(P = 分别为0.0058和0.0153)。此外，高PLR值与肿瘤大小相关(P = 0.020)。我们的结果提示，术前PLR可能是肝切除ICC患者OS和RFS的一个新的独立预后因素。
The elevated platelet-to-lymphocyte ratio (PLR), determined using an easy blood test based on platelet and lymphocyte counts, is reported to be a predictor of poor survival in patients with several cancers. The prognostic role of preoperative PLR in patients with intrahepatic cholangiocarcinoma (ICC) has, until now, been rarely investigated. The purpose of our study was to evaluate the prognostic significance of PLR in a large cohort of ICC patients after hepatic resection. We obtained data from 322 consecutive nonmetastatic ICC patients who underwent hepatectomy without preoperative therapy between 2005 and 2011. Clinicopathological parameters, including PLR, were evaluated. Overall survival (OS) and recurrence-free survival (RFS) were assessed using the Kaplan–Meier method. Using multivariate Cox regression models, the independent prognostic value of preoperative PLR was determined. Our results showed that PLR represents an independent adverse prognostic factor for OS and RFS in ICC patients using univariate and multivariate analyses. The optimal PLR cutoff value was 123 using receiver operating curve analyses. The 5-year OS and RFS rates after hepatectomy were 30.3% and 28.9% for the group with PLR 123 greater, compared with 46.2% and 39.4% for the group with PLR less than 123 (P = 0.0058 and 0.0153, respectively). In addition, high PLR values were associated with tumor size (P = 0.020). Our results suggest that preoperative PLR might represent a novel independent prognostic factor for OS and RFS in ICC patients with hepatic resection.