血常规参数对肾透明细胞癌的预后意义
发布时间：2019-02-13 17:15
【摘要】：目的探讨术前血常规中中性粒细胞、淋巴细胞、中性粒淋巴细胞比值、血红蛋白、血小板、血小板淋巴细胞比值对肾透明细胞癌(CCRCC)患者预后的意义。 方法回顾性分析初诊并术后病理证实的292例CCRCC患者的临床资料及随访情况,根据第七版《诊断学》血红蛋白和血小板的正常界值将患者分为贫血组和正常组、血小板正常组和增高组,应用最小p值法获得其余四项参数的最佳临界值并分别将其分为较高和较低组,分别应用Kaplan-Meier、Log-rank法和Cox回归模型进行单因素和多因素分析。 结果中性粒细胞(3.47×109/L,P=0.025)、中性粒淋巴细胞比值(1.28,P=0.042)和血小板淋巴细胞比值(200,P=0.001)的最佳临界值有统计学意义。单因素分析结果显示,发病方式、中性粒细胞计数、中性粒淋巴细胞比值、血小板计数、血小板淋巴细胞比值、肿瘤坏死情况、病理分级、病理T分期、肿瘤大小、临床分期是预后因素。多因素分析结果显示,中性粒细胞计数(P=0.032)、病理T分期(P=0.032)和临床分期(P=0.009)是CCRCC患者PFS (progression free survival)的独立预后因素,临床分期(P=0.049)也是CCRCC患者OS (overall survival)的独立预后因素。 结论术前外周血中性粒细胞计数较高是CCRCC患者预后不良的独立预后因素,病理T分期和临床分期也是CCRCC患者的独立预后因素。
[Abstract]:Objective to investigate the prognostic significance of preoperative blood routine neutrophilic granulocyte, lymphocyte, neutrophil ratio, hemoglobin and platelet lymphocyte ratio in patients with renal clear cell carcinoma (CCRCC). Methods the clinical data and follow-up data of 292 patients with CCRCC were retrospectively analyzed. The patients were divided into anemia group and normal group according to the normal value of hemoglobin and platelets in the seventh edition. The best critical values of the other four parameters were obtained by the method of minimum p value and divided into higher and lower groups respectively. Kaplan-Meier,Log-rank method and Cox regression model were used for single factor and multivariate analysis respectively. Results the optimal critical values of neutrophils (3.47 脳 10 ~ 9 / L), neutrophil lymphocyte ratios (1.28) and platelet-lymphocyte ratios (200) were statistically significant. Univariate analysis showed that the pathogenesis, neutrophil count, neutrophil ratio, platelet count, platelet lymphocyte ratio, tumor necrosis, pathological grade, pathological T stage, tumor size, Clinical staging is a prognostic factor. Multivariate analysis showed that neutrophil count (P0. 032), pathological T stage (P0. 032) and clinical stage (P0. 009) were independent prognostic factors of PFS (progression free survival) in patients with CCRCC. Clinical staging (P0. 049) is also an independent prognostic factor for OS (overall survival) in CCRCC patients. Conclusion the high peripheral blood neutrophil count before operation is an independent prognostic factor for poor prognosis in patients with CCRCC. Pathological T stage and clinical stage are also independent prognostic factors in CCRCC patients.
【学位授予单位】：青岛大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R737.11
本文编号：2421770
[Abstract]:Objective to investigate the prognostic significance of preoperative blood routine neutrophilic granulocyte, lymphocyte, neutrophil ratio, hemoglobin and platelet lymphocyte ratio in patients with renal clear cell carcinoma (CCRCC). Methods the clinical data and follow-up data of 292 patients with CCRCC were retrospectively analyzed. The patients were divided into anemia group and normal group according to the normal value of hemoglobin and platelets in the seventh edition. The best critical values of the other four parameters were obtained by the method of minimum p value and divided into higher and lower groups respectively. Kaplan-Meier,Log-rank method and Cox regression model were used for single factor and multivariate analysis respectively. Results the optimal critical values of neutrophils (3.47 脳 10 ~ 9 / L), neutrophil lymphocyte ratios (1.28) and platelet-lymphocyte ratios (200) were statistically significant. Univariate analysis showed that the pathogenesis, neutrophil count, neutrophil ratio, platelet count, platelet lymphocyte ratio, tumor necrosis, pathological grade, pathological T stage, tumor size, Clinical staging is a prognostic factor. Multivariate analysis showed that neutrophil count (P0. 032), pathological T stage (P0. 032) and clinical stage (P0. 009) were independent prognostic factors of PFS (progression free survival) in patients with CCRCC. Clinical staging (P0. 049) is also an independent prognostic factor for OS (overall survival) in CCRCC patients. Conclusion the high peripheral blood neutrophil count before operation is an independent prognostic factor for poor prognosis in patients with CCRCC. Pathological T stage and clinical stage are also independent prognostic factors in CCRCC patients.
【学位授予单位】：青岛大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R737.11
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