Diagnostic value of post-operative platelet-to-white blood cell ratio after splenectomy in patients with advanced ovarian cancer
Diagnostic value of post-operative platelet-to-white blood cell ratio after splenectomy in patients with advanced ovarian cancer
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DOI：
10.1136/ijgc-2019-000712
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发表时间：
2019-10-01
影响因子：
4.8
通讯作者：
Fotopoulou, Christina
中科院分区：
文献类型：
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作者：
Lathouras, Konstantinos;Panagakis, Georgios;Fotopoulou, Christina
脾脏切除术引起的血小板增多和白细胞增多可能会使术后感染或脓毒症的早期诊断变得模糊。目的探讨血小板/白色细胞比值在外伤患者脾切除术后反应性改变与潜伏性感染鉴别诊断中的应用价值。方法回顾性评价了2013年1月至2018年10月期间在两个大型欧洲妇科癌症中心接受脾切除术的所有卵巢癌连续患者。主要结果指标为术后第1、5和7天的白色血细胞计数、血小板计数和血小板与白色血细胞比率。根据Clavien-Dindo分类，这些与手术结果和发病率相关。应用二项逻辑回归评估第5天血小板与白色血细胞比率、白色血细胞计数和血小板计数对预测III级术后脓毒症的预测价值。结果95例卵巢癌患者（平均年龄54岁，范围18-75）被确定。17名患者（17.9%）发生了III级术后脓毒症。在所有术后患者中，第5天的平均白色血细胞计数降低（从15.4x10（3）/mu L降至11.4x10（3）/mu L），而平均血小板计数升高（从260.7x10（3）/mu L升至385.3x10（3）/mu L）。高血小板计数（> 313 × 10（3）/μ L）未能显示任何预测价值（OR=0.94; 95%CI 0.30 - 3.0; p=0.921）。第5天血小板与白色血细胞比率较低（14.5 × 10（3）/μ L）（OR=11.0; 95% CI 3.3 - 36.2; p
Introduction Splenectomy-induced thrombocytosis and leukocytosis may obscure the early diagnosis of post-operative infection or sepsis. In trauma patients after splenectomy, a platelet-to-white blood cell ratio of Objective To determine whether the platelet-to-white blood cell ratio can be applied to differentiate between reactive post-operative changes and latent infection. Methods All consecutive patients with ovarian cancer who underwent splenectomy between January 2013 and October 2018 in two large European gynecological cancer centers were retrospectively evaluated. Main outcome measures were white blood cell count, platelet count, and platelet-to-white blood cell ratio on post-operative days 1, 5, and 7. These were correlated with surgical outcome and morbidity according to the Clavien-Dindo classification. A binomial logistic regression was applied to assess the predictive value of day 5 platelet-to-white blood cell ratio, white blood cell count, and platelet count for predicting grade III post-operative sepsis. Results Ninety-five patients with ovarian cancer (mean age 54 years, range 18-75) were identified. Seventeen patients (17.9%) developed a grade III post-operative sepsis. In all post-operative patients, mean white blood cell count on day 5 decreased (from 15.4x10(3)/mu L to 11.4x10(3)/mu L), while the mean platelet count rose (from 260.7x10(3)/mu L to 385.3x10(3)/mu L). A high platelet count (>313x10(3)/mu L) failed to show any predictive value (OR=0.94; 95% CI 0.30 to 3.0; p=0.921). A low platelet-to-white blood cell ratio (14.5x10(3)/mu L) on day 5 (OR=11.0; 95% CI 3.3 to 36.2; p