【摘要】：目的本研究旨在探討治療前外周血中淋巴細(xì)胞與單核細(xì)胞比值(LMR)在接受根治性放化療的食管鱗癌患者的近期療效預(yù)測與預(yù)后評估中的意義。病例與方法回顧性分析2012年1月至2013年12月在山東省腫瘤醫(yī)院接受根治性放化療的食管鱗狀細(xì)胞癌患者162例。分別以外周血淋巴細(xì)胞絕對值(ALC)的中位值1.65×109/L、外周血單核細(xì)胞絕對值的中位值(AMC)0.48×109/L、外周血淋巴細(xì)胞與單核細(xì)胞比值(LMR)的中位值4.02為臨界值,將患者分為低ALC組(≤1.65×109/L,n=84)和高ALC組(1.65×109/L,n=78);低AMC組(≤0.48×109/L,n=84)和高AMC組(0.48×109/L,n=78);低LMR組(≤4.02,n=81例)和高LMR組(4.10,n=81例),比較低ALC組和高ALC組、低AMC組和高AMC組、低LMR組和高LMR組間患者的臨床病理學(xué)資料,并分析其與食管癌根治性放化療后客觀臨床緩解率、生存等指標(biāo)的相關(guān)性。結(jié)果在接受根治性放化療的食管癌患者中,高ALC組患者的完全緩解率(CR率)明顯高于低ALC組患者(p=0.040),高LMR組患者的CR率明顯高于低LMR組(p0.001),高AMC組患者與低AMC組患者的CR率未見明顯差異(p=0.087)。CR組患者的ALC值明顯高于非CR組患者(2.00±0.84 vs.1.69±0.58,p=0.018),CR組的患者的LMR值明顯高于非CR組患者(4.89±1.17 vs.3.87±1.29,p0.001),CR組患者的AMC值與非CR組患者的AMC未見明顯差異(p=0.052)。多因素回歸分析顯示LMR值是影響接受根治性放化療的食管癌患者近期療效的獨(dú)立影響因素(p=0.008)。在生存分析中,單因素分析結(jié)果顯示臨床T分期、臨床腫瘤分期、近期療效、ALC和LMR是影響食管癌患者PFS和OS的有意義因素。Cox多因素結(jié)果分析顯示,臨床T分期(p=0.043,HR=0.65;95%CI:0.43-1.00)、臨床近期療效(p=0.006,HR=0.52;95%CI:0.33-0.83)、ALC(p=0.048,HR=1.50;95%CI:1.00-2.22)、LMR(p0.001,HR=1.94;95%CI:1.29-2.91)是影響患者PFS的獨(dú)立預(yù)后因素。臨床近期療效(p=0.027,HR=0.55;95%CI:0.33-0.93)和LMR(p=0.008,HR=1.86;95%CI:1.17-2.95)是影響患者食管癌患者OS的獨(dú)立預(yù)后因素。結(jié)論1.治療前外周血中淋巴細(xì)胞絕對值可以作為預(yù)測接受根治性放化療治療的食管鱗狀細(xì)胞癌患者PFS的獨(dú)立影響因素。2.治療前外周血中LMR值是影響接受根治性放化療治療的食管鱗狀細(xì)胞癌患者近期療效及預(yù)后的獨(dú)立影響因素。
[Abstract]:Objective to investigate the significance of the ratio of lymphocyte to monocyte in peripheral blood of patients with esophageal squamous cell carcinoma (ESCC) with radical radiotherapy and chemotherapy before treatment. Cases and methods 162 patients with esophageal squamous cell carcinoma who received radical radiotherapy and chemotherapy from January 2012 to December 2013 were retrospectively analyzed. The median value of peripheral blood lymphocyte absolute value (ALC) was 1.65 脳 10 9 / L, and the median value of peripheral blood monocyte absolute value (AMC) was 0.48 脳 10 9 / L, respectively. The median value of (LMR) in peripheral blood lymphocyte to monocyte ratio was 4.02. The patients were divided into low ALC group (鈮，

本文編號：2342086