临床荟萃

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血常规相关指标在恶性腹水患者中的预后价值

  

  1. 沧州市中心医院  消化一科,  河北 沧州 061001
  • 出版日期:2019-09-20 发布日期:2019-11-19
  • 通讯作者: 郑国启,Email:czzxyyxhk@126.com

Analysis of prognostic value of hematological indexes in patients with malignant ascites

  1. Department of Gastroenterology,  Cangzhou Central Hospital,  Cangzhou 061001,China
  • Online:2019-09-20 Published:2019-11-19
  • Contact: Corresponding author:Zheng Guoqi, Email:czzxyyxhk@126.com

摘要: 目的  探讨恶性腹水患者血常规相关指标的变化及常用临床指标对预后的影响。方法  回顾分析经病理学首次确诊的恶性腹水249例,评估恶性腹水组与对照组、腹膜恶性间皮瘤(MPeM)与腹膜转移癌(PC)患者的血常规相关指标的差异,分析年龄、性别、中性粒细胞/淋巴细胞比值(NLR)、血小板/淋巴细胞比值(PLR)、单核细胞/淋巴细胞比值(MLR);血乳酸脱氢酶(lactic dehydrogenase, LDH)、化疗治疗及脏器转移对预后的影响。结果  确诊恶性腹水的患者249例,MPeM占41%, PC占59%。单因素分析提示性别、NLR、PLR、MLR、血LDH、化疗治疗及脏器转移为预后因素。多因素分析提示LDH、脏器转移及NLR为恶性腹水患者的独立预后因素。结论  恶性腹水患者血LDH、NLR越低,预后越好,早期积极治疗对提高生存率有重要意义。

关键词: 腹水, 间皮瘤, 肿瘤, 预后, 实验室技术和方法

Abstract: Objective  To investigate the differences of the blood parameters in malignant ascites(MA),  and evaluate their influence on relationship with clinical prognosis. Methods  249 patients with pathologically proven MA were retrospectively reviewed. Investigation was performed in the changes of hematological indexes between MA group and control group,  also between malignant peritoneal mesothelioma(MPeM)   group and peritoneal carcinomatosis(PC) group. Age, sex, neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR) and monocyte/lymphocyte ratio (MLR) were analyzed.Influenceofblood lactic dehydrogenase(LDH), chemotherapy and viscera transfer on prognosis were analyzed.Results  Of the 249  MA patients who were initially difficult to identify benign/malignant ascites, MPeM accounted for 41%,  and PC accounted for 59%. The single factor analysis indicated that gender,  NLR,  PLR,  MLR,  LDH,  chemotherapy,  other organ metastasis were factors affecting  OS of MA patients,  but multivariate analysis indicated that LDH, other organ metastasis and NLR were independent factors  affecting  OS of MA patients.Conclusion  MA patients with lower LDH and NLR have a better prognosis. Early active treatment is of great significance for improving the survival rate of MA.

Key words: ascites, mesothelioma, neoplasmas, prognosis, laboratory techniques and procedures