Wu Ying, Zhou Danyang, Zhang Guoping, Yi Fengming, Feng Long
Department of Oncology, The Second Affiliated Hospital of Nanchang University, 1 Minde Road, Nanchang, Jiangxi 330006, China.
Jiangxi Key Laboratory of Clinical and Translational Cancer Research, Nanchang, Jiangxi 330006, China.
Gastroenterol Res Pract. 2019 Jan 28;2019:8506967. doi: 10.1155/2019/8506967. eCollection 2019.
Although prognostic markers are important to establish therapeutic strategies in patients for conducting radical resection of cholangiocarcinoma (CCA), there is still a lack of simple, valid, and repeatable markers in clinical settings. We aim to evaluate the prognostic value of the preoperative serum platelet-lymphocyte ratio (PLR) in CCA patients who underwent radical resection.
We retrospectively analyzed CCA patients who underwent radical resection surgery in our institution from January 2011 to June 2016. Baseline PLR and other clinical pathological data were measured when patients were diagnosed initially. The prognostic value of PLR in overall survival (OS) and progression-free survival (PFS) were analyzed with the Cox proportional hazard model and the Kaplan-Meier method.
This study retrospectively analyzed 119 patients who underwent radical resection of CCA. During a median follow-up time of 11.0 months, there were 99.2% recurrences and 42.9% who died, and the median OS and PFS were 9.4 months and 7.4 months, respectively. Multivariate Cox analysis identified that elevated levels of PLR (PLR > 157.25) as a significant factor predicted poorer OS ( = 0.018, HR: 2.160, 95% CI: 1.139-4.096) and PFS ( = 0.005, HR: 1.930, 95% CI: 1.220-3.053). In subgroup analysis, PLR also effectively predicted OS ( = 0.016, HR: 2.515, 95% CI: 1.143-5.532) and PFS ( = 0.042, HR: 1.908, 95% CI: 0.982-3.713) in CCA patients with positive lymphatic metastasis and/or positive surgical margin who required adjuvant therapy.
The preoperative serum PLR is an independent prognostic factor for OS and PFS in CCA patients after radical resection, including patients requiring adjuvant therapy.
尽管预后标志物对于制定胆管癌（CCA）患者根治性切除的治疗策略很重要，但临床环境中仍缺乏简单、有效且可重复的标志物。我们旨在评估术前血清血小板-淋巴细胞比率（PLR）在接受根治性切除的CCA患者中的预后价值。
我们回顾性分析了2011年1月至2016年6月在我院接受根治性切除手术的CCA患者。在患者初次诊断时测量基线PLR和其他临床病理数据。采用Cox比例风险模型和Kaplan-Meier方法分析PLR对总生存期（OS）和无进展生存期（PFS）的预后价值。
本研究回顾性分析了119例接受CCA根治性切除的患者。在中位随访时间11.0个月期间，复发率为99.2%，死亡率为42.9%，中位OS和PFS分别为9.4个月和7.4个月。多因素Cox分析确定，PLR水平升高（PLR>157.25）是预测OS较差（P = 0.018，HR：2.160，95%CI：1.139 - 4.096）和PFS较差（P = 0.005，HR：1.930，95%CI：1.220 - 3.053）的重要因素。在亚组分析中，PLR在需要辅助治疗的有阳性淋巴结转移和/或手术切缘阳性的CCA患者中也有效预测了OS（P = 0.016，HR：2.515，95%CI：1.143 - 5.532）和PFS（P = 0.042，HR：1.908，95%CI：0.982 - 3.713）。
术前血清PLR是CCA患者根治性切除后OS和PFS的独立预后因素，包括需要辅助治疗的患者。
