三个血液学指标对原发四肢高度恶性骨肉瘤具有预后价值

发布时间：2018-06-28 09:58

  本文选题：骨肉瘤 + 预后　； 参考：《浙江大学》2017年硕士论文

【摘要】：目的:虽然碱性磷酸酶(ALP)和乳酸脱氢酶(LDH)被认为是骨肉瘤的有效预后因素,但对于骨肉瘤仍然需要更多有用的预后生物标志物来进一步明确个体患者的预后,而纤维蛋白原(FBG)已经被证明可以预测多种类型癌症的临床结局,然而,其对骨肉瘤患者预后的影响尚未被探索。本研究试图明确ALP、LDH以及FBG对于骨肉瘤预后的意义。方法:对2006年12月至2011年12月间的106例原发性,高级别的四肢骨肉瘤患者进行回顾性研究,以评估新辅助化疗前后外周血ALP,LDH和FBG水平及其化疗前后下降率对于骨肉瘤的预后价值。采用接收者工作特征曲线(ROC曲线)以确定这些预后指标的分界点,并根据分界点分组。分析这些指标与年龄,性别,转移和病理性骨折等临床病理因素之间的关系来鉴定两组的可比性。采用Kaplan-Meier法分析它们对总生存期的影响。Cox比例风险模型用于确定这些预后生物标志物对存活分布的独立意义。结果:对于原发性高度恶性四肢骨肉瘤患者,新辅助化疗前LDH210U/L,新辅助化疗后LDH215U/L,新辅助化疗后FBG2.8g/L,化疗前后FBG下降率≤10%提示较差的预后(p0.05)。Cox比例风险模型进一步证实了该结果。结论:较高的新辅助化疗前和新辅助化疗后血清乳酸脱氢酶水平,较高的新辅助化疗后血浆纤维蛋白原水平和新辅助化疗前后血浆纤维蛋白原较低的下降率预示着原发性高度恶性四肢骨肉瘤患者较差的生存预后。纤维蛋白原可以作为新的预测骨肉瘤患者5年生存率的有价值的预测因子。
[Abstract]:Objective: although alkaline phosphatase (ALP) and lactate dehydrogenase (LDH) are considered to be effective prognostic factors in osteosarcoma, more useful prognostic biomarkers are needed for osteosarcoma to further determine the prognosis of individual patients. Fibrinogen (FBG) has been shown to predict the outcome of many types of cancer, however, its impact on the prognosis of osteosarcoma patients has not been explored. The purpose of this study was to determine the prognostic significance of ALP LDH and FBG in osteosarcoma. Methods: 106 patients with primary and high grade osteosarcoma of extremities from December 2006 to December 2011 were retrospectively studied. To evaluate the prognostic value of ALPfid LDH and FBG in peripheral blood before and after neoadjuvant chemotherapy and the decrease rate before and after chemotherapy in osteosarcoma. The receiver working characteristic curve (ROC curve) was used to determine the boundary points of these prognostic indicators and to group them according to the boundary points. The comparability of the two groups was evaluated by analyzing the relationship between these indicators and the clinicopathological factors such as age, sex, metastasis and pathological fracture. Kaplan-Meier method was used to analyze their influence on total survival. Cox proportional risk model was used to determine the independent significance of these prognostic biomarkers for survival distribution. Results: in patients with primary malignant osteosarcoma of extremities, LDH210U / L before neoadjuvant chemotherapy, LDH215U / L after neoadjuvant chemotherapy, FBG2.8g/ L after neoadjuvant chemotherapy, and the decrease rate of FBG before and after chemotherapy 鈮，

本文编号：2077601