血小板相关生物标志物在接受新辅助放化疗的直肠癌患者中的预后价值：一项回顾性研究。

Prognostic value of platelet-associated biomarkers in rectal cancer patients received neoadjuvant chemoradiation: A retrospective study.

机构信息

General surgery, Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, No. 127, Dongming road, Zhengzhou, Henan Province, China.

Department of SICU, Affiliated Children's Hospital of Zhengzhou University, Henan Children's Hospital, Zhengzhou, Henan Province, China.

出版信息

Cancer Radiother. 2021 Apr;25(2):147-154. doi: 10.1016/j.canrad.2020.06.030. Epub 2021 Jan 7.

DOI:10.1016/j.canrad.2020.06.030

PMID:33423969

Abstract

PURPOSE

Platelet volume has been shown to prognostic value in patients with colorectal cancer. However, the changes of other platelet-associated biomarkers in rectal cancer patients, before and after the neoadjuvant chemoradiation therapy (NACRT), remain unclear. In this study, we investigated the prognostic value of platelet-associated biomarkers in rectal cancer patients with NACRT.

PATIENTS AND METHODS

A total of 75 patients with locally advanced (T3-4 or N+) rectal cancer (LARC) cancer were selected and followed up from the Affiliated Cancer Hospital of Zhengzhou University between June 2013 and September 2016. The data of platelet-associated biomarkers, including the platelet count, platelet to lymphocyte ratio (PLR), lymphocyte to monocyte ratio (LMR), mean platelet volume (MPV), and platelet distribution width (PDW) both pre- and post- NACRT, were collected. The associations between these platelet-associated biomarkers and the overall survival (OS), as well as disease-free survival (DFS) of patients, were analysed. Patients were divided into groups with high or low values of the platelet-associated biomarkers, and the outcomes were compared by using Cox regression and Kaplan-Meier analysis.

RESULTS

We found that pre-PLR (HR: 4.104; 95%CI: 1.411-11.421; P=0.009) and pre-LMR (HR: 0.384; 95%CI: 0.124-1.185; P=0.066) could predict the OS in LARC patients after NACRT by multivariate Cox regression analysis, a cut-off value of pre-PLR>7.02 and pre-LMR ≤7.10 could be used as independent prognostic factors for OS by Kaplan-Meier method. The pre-MPV value could be used as an independent prognostic factor for DFS by Kaplan-Meier analysis (P=0.037). Moreover, post-CEA was correlated with OS and DFS in LARC patients with NACRT.

CONCLUSION

In LARC patients with NACRT, the pre-PLR and pre-LMR are independent prognostic factors for OS, while pre-MPV has predictive value for DFS.

摘要

目的

已有研究表明血小板体积与结直肠癌患者的预后有关。然而，新辅助放化疗（NACRT）前后直肠癌患者其他血小板相关生物标志物的变化尚不清楚。本研究旨在探讨 NACRT 前后直肠癌患者血小板相关生物标志物的预后价值。

方法

选取 2013 年 6 月至 2016 年 9 月期间在郑州大学附属肿瘤医院接受治疗的 75 例局部晚期（T3-4 或 N+）直肠癌（LARC）患者为研究对象，并进行随访。收集患者 NACRT 前后的血小板相关生物标志物数据，包括血小板计数、血小板与淋巴细胞比值（PLR）、淋巴细胞与单核细胞比值（LMR）、平均血小板体积（MPV）和血小板分布宽度（PDW）。分析这些血小板相关生物标志物与患者总生存期（OS）和无病生存期（DFS）的相关性。根据血小板相关生物标志物的高低将患者分为高值组和低值组，采用 Cox 回归和 Kaplan-Meier 分析比较两组的预后。

结果

多因素 Cox 回归分析显示，NACRT 前 PLR（HR：4.104；95%CI：1.411-11.421；P=0.009）和 NACRT 前 LMR（HR：0.384；95%CI：0.124-1.185；P=0.066）可预测 LARC 患者 NACRT 后的 OS。Kaplan-Meier 法分析显示，NACRT 前 PLR>7.02 和 LMR≤7.10 可作为 OS 的独立预后因素。NACRT 前 MPV 值可作为 DFS 的独立预后因素（P=0.037）。此外，NACRT 后 CEA 与 LARC 患者的 OS 和 DFS 相关。