本文選題：骨肉瘤 + 預(yù)后��； 參考：《浙江大學(xué)》2017年碩士論文

【摘要】：目的:雖然堿性磷酸酶(ALP)和乳酸脫氫酶(LDH)被認(rèn)為是骨肉瘤的有效預(yù)后因素,但對于骨肉瘤仍然需要更多有用的預(yù)后生物標(biāo)志物來進(jìn)一步明確個體患者的預(yù)后,而纖維蛋白原(FBG)已經(jīng)被證明可以預(yù)測多種類型癌癥的臨床結(jié)局,然而,其對骨肉瘤患者預(yù)后的影響尚未被探索。本研究試圖明確ALP、LDH以及FBG對于骨肉瘤預(yù)后的意義。方法:對2006年12月至2011年12月間的106例原發(fā)性,高級別的四肢骨肉瘤患者進(jìn)行回顧性研究,以評估新輔助化療前后外周血ALP,LDH和FBG水平及其化療前后下降率對于骨肉瘤的預(yù)后價值。采用接收者工作特征曲線(ROC曲線)以確定這些預(yù)后指標(biāo)的分界點(diǎn),并根據(jù)分界點(diǎn)分組。分析這些指標(biāo)與年齡,性別,轉(zhuǎn)移和病理性骨折等臨床病理因素之間的關(guān)系來鑒定兩組的可比性。采用Kaplan-Meier法分析它們對總生存期的影響。Cox比例風(fēng)險模型用于確定這些預(yù)后生物標(biāo)志物對存活分布的獨(dú)立意義。結(jié)果:對于原發(fā)性高度惡性四肢骨肉瘤患者,新輔助化療前LDH210U/L,新輔助化療后LDH215U/L,新輔助化療后FBG2.8g/L,化療前后FBG下降率≤10%提示較差的預(yù)后(p0.05)。Cox比例風(fēng)險模型進(jìn)一步證實(shí)了該結(jié)果。結(jié)論:較高的新輔助化療前和新輔助化療后血清乳酸脫氫酶水平,較高的新輔助化療后血漿纖維蛋白原水平和新輔助化療前后血漿纖維蛋白原較低的下降率預(yù)示著原發(fā)性高度惡性四肢骨肉瘤患者較差的生存預(yù)后。纖維蛋白原可以作為新的預(yù)測骨肉瘤患者5年生存率的有價值的預(yù)測因子。
[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，

本文編號：2077601