卵巢癌患者血浆纤维蛋白原浓度与单核细胞与淋巴细胞比值联合检测的临床及预后意义
Clinical and prognostic significance of combined plasma fibrinogen concentrations and the monocyte-to-lymphocyte ratio in patients with ovarian cancer.
作者信息
Cao Yuanyuan, Ni Xiuwen, Wang Yong, Wang Lejian, Yuan Kai, Gan Guofang, Zhang Kunming, Zhao Zhidi, Fei Xianming
机构信息
Department of Laboratory Medicine, Hangzhou Cancer Hospital, Hangzhou 310002, China.
Central Blood Bank of Jiaxing, Jiaxing 314001, China.
出版信息
Ann Transl Med. 2019 Jun;7(11):242. doi: 10.21037/atm.2019.04.78.
BACKGROUND
Fibrinogen concentrations and the monocyte-to-lymphocyte ratio (FC-MLR) are associated with progression and outcomes of many malignancies. This study aimed to assess the clinical and prognostic significance of the combination of plasma FC-MLR in patients with ovarian cancer.
METHODS
A total of 155 patients with epithelial ovarian cancer (EOC) and 102 patients with benign gynecological disease were retrospectively reviewed. The clinical and pathological data of all patients with EOC were analyzed. Plasma fibrinogen concentrations and the white blood cell (WBC) count were measured to calculate the MLR and neutrophil-to-lymphocyte ratio (NLR). Furthermore, the association of fibrinogen concentrations, the MLR, and FC-MLR with tumor stage, lymphatic and venous metastasis, and 5-year survival was assessed. Regression analysis was performed to evaluate the risk factors for progression of EOC. Receiver operating characteristic (ROC) curves were constructed to assess the prognostic power of plasma fibrinogen concentrations, the MLR, and FC-MLR, and to determine the optimal cutoff values of fibrinogen and the MLR. On the basis of the cutoff values, patients with EOC were divided into three groups: no abnormality, either increased, and both increased groups, respectively. The effect of FC-MLR on overall survival was calculated by the Kaplan-Meier method and compared by the log-rank test in the three groups.
RESULTS
Patients with EOC had higher fibrinogen concentrations and a higher MLR than did controls (both P<0.01), and FC-MLR was closely associated with tumor stage and lymphatic and venous metastasis (all P<0.001). Furthermore, FC-MLR was an independent risk factor for progression of EOC (OR =8.985; 95% CI: 4.912-27.166; P<0.001), and patients with high fibrinogen concentrations and a high MLR showed a lower 5-year survival rate (P<0.001).
CONCLUSIONS
FC-MLR may be used as a predictor of tumor progression and prognosis for ovarian cancer.
背景
纤维蛋白原浓度和单核细胞与淋巴细胞比值（FC-MLR）与许多恶性肿瘤的进展及预后相关。本研究旨在评估血浆FC-MLR联合检测在卵巢癌患者中的临床及预后意义。
方法
回顾性分析155例上皮性卵巢癌（EOC）患者及102例良性妇科疾病患者的资料。分析所有EOC患者的临床及病理数据。检测血浆纤维蛋白原浓度及白细胞（WBC）计数，以计算MLR及中性粒细胞与淋巴细胞比值（NLR）。此外，评估纤维蛋白原浓度、MLR及FC-MLR与肿瘤分期、淋巴及静脉转移以及5年生存率的相关性。进行回归分析以评估EOC进展的危险因素。绘制受试者工作特征（ROC）曲线，评估血浆纤维蛋白原浓度、MLR及FC-MLR的预后价值，并确定纤维蛋白原及MLR的最佳截断值。根据截断值，将EOC患者分为三组：无异常组、单项升高组及两项均升高组。采用Kaplan-Meier法计算FC-MLR对总生存的影响，并通过log-rank检验在三组间进行比较。
结果
EOC患者的纤维蛋白原浓度及MLR高于对照组（均P<0.01），且FC-MLR与肿瘤分期、淋巴及静脉转移密切相关（均P<0.001）。此外，FC-MLR是EOC进展的独立危险因素（OR =8.985；95%CI：4.912-27.166；P<0.001），纤维蛋白原浓度高且MLR高的患者5年生存率较低（P<0.001）。
结论
FC-MLR可作为卵巢癌肿瘤进展及预后的预测指标。
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