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术前纤维蛋白原联合中性粒细胞与淋巴细胞比值评分与非小细胞肺癌临床病理特征及预后的关系

  

  1. 迁安市人民医院  检验科,河北 迁安 064400
  • 出版日期:2016-07-05 发布日期:2016-07-08
  • 通讯作者: 通信作者:郝玉杰,Email: haoyujie888@126.com

Association of COFNLR with clinicopathological characteristics and prognosis of patients with nonsmallcell lung cancer after curative resection

  1. Department of Clinical Laboratory, People’s Hospital of Qian’an,Qian’an 064400,China
  • Online:2016-07-05 Published:2016-07-08
  • Contact: Corresponding author:Hao Yujie,Email: haoyujie888@126.com

摘要: 目的探讨术前纤维蛋白原 (fibrinogen,Fbg) 联合中性粒细胞与淋巴细胞比值(neutrophiltolymphocyte ratio,NLR)评分(COFNLR)与非小细胞肺癌(nonsmallcell lung cancer,NSCLC)患者临床病理特征及预后的相关性。方法回顾性分析我院行根治性手术切除且具有完整信息的122例NSCLC患者的临床病理资料。根据COFNLR评分原则分为3组:COFNLR0分 49例,COFNLR1分41例,COFNLR2分32例。根据患者术前的Fbg及NLR水平,构建新的COFNLR参数。χ2检验分析其与患者临床病理因素的相关性,KaplanMeier法进行单因素生存分析,Logrank法进行检验,Cox比例风险模型进行多因素回归分析。结果术前COFNLR水平与性别、分化程度、肿瘤位置、T分期、临床分期密切相关(P<0.05);单因素分析结果显示吸烟史、肿瘤分化程度、T分期、有无淋巴结转移、Fbg、NLR水平、COFNLR评分是影响患者预后的因素(P<0.05),多因素分析表明分化程度(P<0.05)、淋巴结转移(P<0.05)及COFNLR(P<0.05)是影响患者预后的独立危险因素。结论NSCLC患者术前COFNLR水平升高与肿瘤进展具有相关性,提示患者预后不良;COFNLR可作为预测NSCLC患者肿瘤进展及预后的具有潜在应用价值的新指标。

关键词: 癌, 非小细胞肺;纤维蛋白原, 中性白细胞浸润, 淋巴细胞;预后

Abstract: Objective  To analyze the combination of preoperative plasma levels of fibrinogen(Fbg) and neutrophiltolymphocyte ratio (COFNLR) with clinicopathologic characteristics as well as the prognosis of nonsmallcell lung cancer (NSCLC) patients after curative resection. Methods  The clinical data of 122 patients with NSCLC who underwent curative resection in our hospital were retrospectively analyzed. A total of  122 patients with NSCLC were divided into three groups based on the criteria of COFNLR: COFNLR 0 group, n=49; COFNLR1 group, n=41; COFNLR2 group, n=32.  The preoperative COFNLR was calculated by combing the fibrinogen and neutrophiltolymphocyte ratio (NLR). The relationship between the COFNLR and clinicopathological features was studied by chisquare test. The postoperative prognostic factors were analyzed using univariate KaplanMeier analysis and multivariate Cox proportional hazards model. Results  The COFNLR was significantly associated with sex, differentiation degrees, T staging, clinical staging(P<0.05). Univariate analysis showed smoking history, differentiation degrees, T staging, lymph node metastasis, plasma levels of fibrinogen,NLR  and  COFNLR were associated with survival (P<0.05). Multivariate analysis identified that differentiation degrees, lymph node metastasis and COFNLR as independent prognostic factors of all the patients(all P<0.05).Conclusion  Preoperative elevated plasma level of COFNLR indicates tumor progression and poor prognosis in patients with NSCLC. The COFNLR may be a potentially new and useful blood marker for predicting tumor progression and the prognosis of patients with NSCLC.

Key words: carcinoma, nonsmallcell lung cancer, fibrinogen, neutrophil infiltration, lymphocytes, prognosis