發(fā)布時間：2019-02-13 17:15

【摘要】：目的探討術(shù)前血常規(guī)中中性粒細(xì)胞、淋巴細(xì)胞、中性粒淋巴細(xì)胞比值、血紅蛋白、血小板、血小板淋巴細(xì)胞比值對腎透明細(xì)胞癌(CCRCC)患者預(yù)后的意義。 方法回顧性分析初診并術(shù)后病理證實的292例CCRCC患者的臨床資料及隨訪情況,根據(jù)第七版《診斷學(xué)》血紅蛋白和血小板的正常界值將患者分為貧血組和正常組、血小板正常組和增高組,應(yīng)用最小p值法獲得其余四項參數(shù)的最佳臨界值并分別將其分為較高和較低組,分別應(yīng)用Kaplan-Meier、Log-rank法和Cox回歸模型進(jìn)行單因素和多因素分析。 結(jié)果中性粒細(xì)胞(3.47×109/L,P=0.025)、中性粒淋巴細(xì)胞比值(1.28,P=0.042)和血小板淋巴細(xì)胞比值(200,P=0.001)的最佳臨界值有統(tǒng)計學(xué)意義。單因素分析結(jié)果顯示,發(fā)病方式、中性粒細(xì)胞計數(shù)、中性粒淋巴細(xì)胞比值、血小板計數(shù)、血小板淋巴細(xì)胞比值、腫瘤壞死情況、病理分級、病理T分期、腫瘤大小、臨床分期是預(yù)后因素。多因素分析結(jié)果顯示,中性粒細(xì)胞計數(shù)(P=0.032)、病理T分期(P=0.032)和臨床分期(P=0.009)是CCRCC患者PFS (progression free survival)的獨立預(yù)后因素,臨床分期(P=0.049)也是CCRCC患者OS (overall survival)的獨立預(yù)后因素。 結(jié)論術(shù)前外周血中性粒細(xì)胞計數(shù)較高是CCRCC患者預(yù)后不良的獨立預(yù)后因素,病理T分期和臨床分期也是CCRCC患者的獨立預(yù)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.
【學(xué)位授予單位】：青島大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R737.11

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