原发性肝癌介治疗与PLR关系.doc

Y151015 治疗前血小板和淋巴细胞比值与原发性肝癌（肝细胞型）经TACE治疗疗效及预后的相关性 马双双，宋金龙*，李金鹏，陈华，肖婉 作者单位：250117 济南，山东省肿瘤医院外九科 山东省医学科学院；*通讯作者 联系电话摘要目的：评价治疗前外周血血小板和淋巴细胞比值（PLR）与III期原发性肝癌TACE治疗疗效及预后的相关性。方法：回顾性分析我院收治的95例经TACE治疗原发性肝癌患者的临床相关资料，绘制ROC曲线分析PLR与TACE治疗疗效的关系，并预测TACE治疗疗效的最佳临界（cutoff）值。建立Logistic回归模型分析影响TACE治疗疗效的独立相关因素，采用单因素及Cox回归模型分析PLR和其他临床病理因素与3年生存率的关系。结果：PLR与TACE的疗效显著相关，预测TACE治疗疗效的PLR最佳临界值约为89，敏感性和特异性分别为0.869和0.676。患者PLR89的3年生存率低于PLR≤89（48.3%vs. 87.5%），差异有统计学意义（P=0.026）。通过单因素分析显示肝硬化、PLR、Child-Pugh 分级、肿瘤直径5cm、门脉癌栓、BCLC 分级是影响HCC 患者预后的危险因素。多因素Cox 回归分析结果显示，肝硬化、PLR、肿瘤直径5cm、门脉癌栓形成及合并肝动脉-门静脉瘘是影响 HCC 患者预后的独立危险因素。结论：治疗前PLR可作为预测肝癌TACE临床疗效的指标之一，术前PLR作为一种全身炎症反应指标，可有效预测TACE治疗疗效并且对预后评估有一定的临床价值。 关键词原发性肝癌肝动脉化疗栓塞术（TACE）血小板与淋巴细胞比值(PLR) 门静脉癌栓（PVTT）肝动脉-门静脉瘘 预后 Association of pre-treatment platelet-to-lymphocyte ratios with response to transcatheter arterial ehemoembolization and clinical outcomes of hepatocellular carcinoma patients MA Shuangshuang, SONG Jinlong*, LI Jinpeng,et al. Department of Surgical Oncology (Interventional Therapy), Shandong Cancer Hospital and Institute, Shandong Academy of Medical Sciences, Jinan, Shandong 250117, P.R. China Abstract Objective: To evaluate the predictive value of pretreatmentplatelet-to-lymphocyte ratios (PLRs) in response to transcatheter arterial ehemoembolization and prognostic outcome in patients with Stages III hepatocellular carcinomacancer. Methods: An investigation was conducted on 95 patients with hepatocellular carcinomacancer, who underwent transcatheter arterial ehemoembolization in Shan Dong Tumor Hospital,Shan Dong. A receiver operating characteristic (ROC) curve was used to determine the best PLR cut-off value in predicting the response to transcatheter arterial ehemoembolization . The relationships between the pretreatment variables and the response to transcatheter arterial ehemoembolization were assessed in univariate and multivariate settings. The overall three-year survival rates were analyzed using the log-rank test