一种基于止血参数的新型评分系统可预测晚期胰腺癌患者的预后。

A novel scoring system based on hemostatic parameters predicts the prognosis of patients with advanced pancreatic cancer.

机构信息

Department of Integrative Oncology, Fudan University Shanghai Cancer Center, Shanghai, 200032, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China.

Department of Cancer Prevention, Fudan University Shanghai Cancer Center, Shanghai, 200032, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China.

出版信息

Pancreatology. 2019 Mar;19(2):346-351. doi: 10.1016/j.pan.2018.12.010. Epub 2019 Jan 2.

DOI:10.1016/j.pan.2018.12.010

PMID:30638854

Abstract

OBJECTIVE

The aim of this study was to evaluate the prognostic value of pre-treatment plasma hemostatic parameters in patients with advanced pancreatic cancer.

METHODS

A total of 320 patients diagnosed with advanced pancreatic cancer between January 1, 2011 to December 31, 2015 were enrolled in this retrospective study. The prognostic significance of hemostatic parameters such as prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen (FBG), platelet count (PLT), mean platelet volume (MPV), plateletcrit (PCT), and platelet distribution width (PDW) was determined by univariate and multivariate Cox hazard models. Then, Kaplan-Meier methods and log-rank tests were performed to compare the survival of patients in different risk groups.

RESULT

Univariate and multivariate analyses showed that prolonged PT, high FBG, and high MPV were independent prognostic factors for poor overall survival (PT > 11.3 s, HR = 1.46, 95%CI = 1.10-1.94, p = 0.009; FBG>2.5 g/L, HR = 1.41, 95%CI = 1.08-1.84, p = 0.011; MPV>12.2 fL, HR = 1.52, 95%CI = 1.13-2.04, p = 0.005). Moreover, all the patients were stratified into three groups by a scoring system based on these three hemostatic markers. The median survival time of the three groups was 8.8 months, 6.3 months and 4.3 months (P < 0.001).

CONCLUSION

PT, FBG and MPV were independent prognostic factors in advanced pancreatic cancer. A novel scoring system based on these hemostatic parameters could be used to predict the survival of patients with advanced pancreatic cancer.

摘要

目的

本研究旨在评估晚期胰腺癌患者治疗前血浆止血参数的预后价值。

方法

回顾性分析 2011 年 1 月 1 日至 2015 年 12 月 31 日期间诊断为晚期胰腺癌的 320 例患者。采用单因素和多因素 Cox 风险模型确定凝血参数（如凝血酶原时间（PT）、活化部分凝血活酶时间（APTT）、纤维蛋白原（FBG）、血小板计数（PLT）、平均血小板体积（MPV）、血小板压积（PCT）和血小板分布宽度（PDW））的预后意义。然后，采用 Kaplan-Meier 方法和对数秩检验比较不同风险组患者的生存情况。

结果

单因素和多因素分析表明，PT 延长、高 FBG 和高 MPV 是总生存期不良的独立预后因素（PT>11.3 s，HR=1.46，95%CI=1.10-1.94，p=0.009；FBG>2.5 g/L，HR=1.41，95%CI=1.08-1.84，p=0.011；MPV>12.2 fL，HR=1.52，95%CI=1.13-2.04，p=0.005）。此外，基于这三个止血标志物，所有患者被分为三个组。三组的中位生存时间分别为 8.8 个月、6.3 个月和 4.3 个月（P<0.001）。