术前外周血炎症指标在腮腺恶性肿瘤中的诊断及预后价值分析

doi:10.3969/j.issn.1005-4979.2022.06.005

摘要/Abstract

摘要：

目的: 探讨术前外周血炎症指标在腮腺恶性肿瘤中的诊断及预后价值。方法: 回顾性分析2014年1月—2017年6月间于郑州大学第一附属医院接受治疗的214例腮腺恶性肿瘤和100例腮腺良性肿瘤患者的临床资料。比较腮腺良、恶性肿瘤组间术前血小板/淋巴细胞比值(platelet/lymphocyte ratio, PLR)、中性粒细胞/淋巴细胞比值(neutrophil/lymphocyte ratio, NLR)和全身炎症反应指数(systemic inflammation response index,SIRI)的差异,评价PLR、NLR和SIRI对腮腺恶性肿瘤的诊断价值及对预后的预测作用。结果: 腮腺恶性肿瘤组的PLR、NLR和SIRI数值均高于良性肿瘤组(P<0.05)。诊断腮腺恶性肿瘤PLR、NLR和SIRI的最佳临界值分别为141.07、2.33、1.10。单因素分析结果显示,T分期、N分期、PLR、NLR及SIRI为腮腺恶性肿瘤患者预后的危险因素(P<0.05);多因素分析结果显示,PLR、NLR及SIRI为独立危险因素(P<0.05)。结论: 术前外周血炎症指标在腮腺良、恶性肿瘤的诊断中具有鉴别价值,对腮腺恶性肿瘤患者的预后可能具有较好的预测价值。

关键词: 外周血炎症指标, 血小板/淋巴细胞比值, 中性粒细胞/淋巴细胞比值, 全身炎症反应指数, 腮腺恶性肿瘤, 预后

Abstract:

Objective: To evaluate the diagnostic and prognostic value of preoperative peripheral blood inflammation indexes in parotid gland malignancies. Methods: The clinical data of 214 patients with malignant parotid gland tumors and 100 patients with benign ones treated in the First Hospital of Zhengzhou University from January 2014 to June 2017 were retrospectively analyzed. The differences in preoperative platelet/lymphocyte ratio(PLR), neutrophil/lymphocyte ratio (NLR), and systemic inflammation response index(SIRI) between the malignant and benign parotid gland tumor groups were compared, and the diagnostic value and predictive effect on prognosis of PLR, NLR and SIRI were analyzed. Results: The values of PLR, NLR and SIRI in the malignant parotid gland tumor group were higher than that in benign tumor group (all P<0.05). The optimal cut-off values for the diagnosis of parotid gland malignancy for PLR, NLR and SIRI were 141.07, 2.33 and 1.10, respectively. The result of univariate analysis showed that T-stage, N-stage, PLR, NLR and SIRI were risk factors of the prognosis of patients with malignant tumors (all P<0.05). The result of multivariate analysis showed that PLR, NLR and SIRI were independent risk factors (all P<0.05). Conclusion: The preoperative peripheral blood inflammation indexes suggest clinical value for differential diagnosis of benign and malignant parotid tumors, and probably have good predictive value for prognosis of patients with malignant parotid gland tumor.

Key words: peripheral blood inflammation index, platelet/lymphocyte ratio, neutrophil/lymphocyte ratio, systemic inflammation response index, malignant parotid gland tumor, prognosis

中图分类号:

R782
R739.8

秦硕, 李冉, 李春梅, 李光辉, 孙明磊. 术前外周血炎症指标在腮腺恶性肿瘤中的诊断及预后价值分析[J]. 《口腔颌面外科杂志》, 2022, 32(6): 362-367.

QIN Shuo, LI Ran, LI Chunmei, LI Guanghui, SUN Minglei. The analysis of diagnostic and prognostic value of preoperative peripheral blood inflammation indexes in malignant parotid gland tumor[J]. 《Journal of Oral and Maxillofacial Surgery》, 2022, 32(6): 362-367.

https://journal06.magtech.org.cn/Jweb_joms/CN/Y2022/V32/I6/362

图/表 5

参考文献 20

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变量	单因素分析		多因素分析
变量	HR(95%CI)	P值	HR(95%CI)	P值
年龄(>60岁/≤60岁)	1.417(0.718~2.796)	0.315
性别(男/女)	1.300(0.726~2.331)	0.377
T分期(T1/T2、T3)	5.699(2.628~12.36)	<0.001	1.132(0.49~2.36)	0.313
N分期(N0/N1、N2)	3.616(1.314~9.951)	0.013	1.416(0.66~3.04)	0.372
PLR(>141.07/≤141.07)	1.731(1.065~2.814)	0.027	11.784(1.572~88.365)	0.016
NLR(>2.33/≤2.33)	1.975(1.245~3.135)	0.004	3.845(1.092~13.534)	0.036
SIRI(>1.10/≤1.10)	1.794(1.123~2.867)	0.015	11.637(1.476~91.734)	0.020

变量	单因素分析		多因素分析
变量	HR(95%CI)	P值	HR(95%CI)	P值
年龄(>60岁/≤60岁)	1.417(0.718~2.796)	0.315
性别(男/女)	1.300(0.726~2.331)	0.377
T分期(T1/T2、T3)	5.699(2.628~12.36)	<0.001	1.132(0.49~2.36)	0.313
N分期(N0/N1、N2)	3.616(1.314~9.951)	0.013	1.416(0.66~3.04)	0.372
PLR(>141.07/≤141.07)	1.731(1.065~2.814)	0.027	11.784(1.572~88.365)	0.016
NLR(>2.33/≤2.33)	1.975(1.245~3.135)	0.004	3.845(1.092~13.534)	0.036
SIRI(>1.10/≤1.10)	1.794(1.123~2.867)	0.015	11.637(1.476~91.734)	0.020

因素	高PLR组		低PLR组		χ²	P值	高NLR组		低NLR组		χ²	P值	高SIRI组		低SIRI组		χ²	P值
因素	例数	百分比	例数	百分比	χ²	P值	例数	百分比	例数	百分比	χ²	P值	例数	百分比	例数	百分比	χ²	P值
年龄/岁					0.033	0.856					0.153	0.70					1.258	0.262
>60	33	24.81	21	25.93			29	26.36	25	24.04			27	22.31	27	29.03
≤60	100	75.19	60	74.07			81	73.64	79	75.96			94	77.69	66	70.97
性别					0.309	0.579					1.113	0.292					8.845	0.003
男	72	54.14	47	58.02			65	59.09	54	51.92			78	64.46	41	44.09
女	61	45.86	34	41.98			45	40.91	50	48.08			43	35.54	52	55.91
N分期					2.844	0.092					0.925	0.336					1.779	0.182
N0	115	86.47	76	93.83			96	87.27	95	91.35			105	86.78	86	92.47
N1、N2	18	13.53	5	6.17			14	12.73	9	8.65			16	13.22	7	7.53
T分期					4.925	0.092					7.828	0.020					4.29	0.117
T1	54	40.60	44	54.32			41	37.27	57	54.81			48	39.67	50	53.76
T2	59	44.36	31	38.27			56	50.91	34	32.69			56	46.28	34	36.56
T3	20	15.03	6	7.41			13	11.81	13	12.50			17	14.05	9	9.68
TNM分期					6.466	0.011					3.179	0.075					5.507	0.019
Ⅰ、Ⅱ	97	72.93	71	87.65			81	73.64	87	83.65			88	72.73	80	86.02
Ⅲ、Ⅳ	36	27.07	10	12.35			29	26.36	17	16.35			33	27.27	13	13.98

因素	高PLR组		低PLR组		χ²	P值	高NLR组		低NLR组		χ²	P值	高SIRI组		低SIRI组		χ²	P值
因素	例数	百分比	例数	百分比	χ²	P值	例数	百分比	例数	百分比	χ²	P值	例数	百分比	例数	百分比	χ²	P值
年龄/岁					0.033	0.856					0.153	0.70					1.258	0.262
>60	33	24.81	21	25.93			29	26.36	25	24.04			27	22.31	27	29.03
≤60	100	75.19	60	74.07			81	73.64	79	75.96			94	77.69	66	70.97
性别					0.309	0.579					1.113	0.292					8.845	0.003
男	72	54.14	47	58.02			65	59.09	54	51.92			78	64.46	41	44.09
女	61	45.86	34	41.98			45	40.91	50	48.08			43	35.54	52	55.91
N分期					2.844	0.092					0.925	0.336					1.779	0.182
N0	115	86.47	76	93.83			96	87.27	95	91.35			105	86.78	86	92.47
N1、N2	18	13.53	5	6.17			14	12.73	9	8.65			16	13.22	7	7.53
T分期					4.925	0.092					7.828	0.020					4.29	0.117
T1	54	40.60	44	54.32			41	37.27	57	54.81			48	39.67	50	53.76
T2	59	44.36	31	38.27			56	50.91	34	32.69			56	46.28	34	36.56
T3	20	15.03	6	7.41			13	11.81	13	12.50			17	14.05	9	9.68
TNM分期					6.466	0.011					3.179	0.075					5.507	0.019
Ⅰ、Ⅱ	97	72.93	71	87.65			81	73.64	87	83.65			88	72.73	80	86.02
Ⅲ、Ⅳ	36	27.07	10	12.35			29	26.36	17	16.35			33	27.27	13	13.98

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