Division of Biliary Tract Surgery, Department of General Surgery, West China Hospital, Sichuan University, Sichuan Province, Chengdu, 610041, China.
Updates Surg. 2024 Aug;76(4):1235-1245. doi: 10.1007/s13304-024-01774-x. Epub 2024 Mar 4.
The platelet to lymphocyte ratio (PLR) is the marker of host inflammation and it is a potential significant prognostic indicator in various different tumors. The serum carbohydrate antigen 19-9 (CA19-9) is a tumor-associated antigen and it is associated with poor prognosis of gallbladder cancer (GBC). We aimed to analyze the prognostic value of the combination of preoperative PLR and CA19-9 in patients with GBC. A total of 287 GBC patients who underwent curative surgery in our institution was included. To analyze the relationship between PLR and CA19-9 and clinicopathological features. A receiver operating characteristic (ROC) curve was used to identify the optimal cutoff value for PLR and CA19-9. The Kaplan-Meier method was used to estimate the overall survival (OS). Meanwhile, the univariate and multivariate Cox regression models were used to assess the risk factors for OS. The cutoff values of 146.82 and 36.32U/ml defined as high PLR and high CA19-9, respectively. Furthermore, survival analysis showed that patients with PLR > 146.82 and CA19-9 > 36.32 U/ml had a worse prognosis than patients with PLR ≤ 146.82 and CA19-9 ≤ 36.32 U/ml, respectively. The multivariate analysis demonstrated that PLR (hazard ratio (HR) = 1.863, 95% CI: 1.366-2.542, P < 0.001) and CA19-9 (HR = 1.412, 95% CI: 1.021-1.952, P = 0.037) were independent prognostic factors in the GBC patients. When we combined these two parameters, the area under the ROC curve increased from 0.624 (PLR) and 0.661 (CA19-9) to 0.711. In addition, the 1-, 3-, and 5-year OS of group A (patients with PLR ≤ 146.82 and CA19-9 ≤ 36.32 U/ml), group B (patients with either of PLR > 146.82 or CA19-9 > 36.32 U/ml) and group C (patients with PLR > 146.82 and CA19-9 > 36.32 U/ml) were 83.6%, 58.6%, 22.5%, 52.4%, 19.5%, 11.5%, and 42.3%, 11.9%, 0%, respectively. The preoperative PLR and serum CA19-9 are associated with prognosis of patients with GBC. The combination of PLR and CA19-9 may serve as a significant prognostic biomarker for GBC patients superior to either PLR or CA19-9 alone.
血小板与淋巴细胞比值（PLR）是宿主炎症的标志物，是各种不同肿瘤潜在的重要预后指标。血清糖链抗原 19-9（CA19-9）是一种肿瘤相关抗原，与胆囊癌（GBC）的预后不良相关。我们旨在分析术前 PLR 和 CA19-9 联合在 GBC 患者中的预后价值。共纳入 287 例在我院接受根治性手术的 GBC 患者。分析 PLR 和 CA19-9 与临床病理特征的关系。使用受试者工作特征（ROC）曲线确定 PLR 和 CA19-9 的最佳截断值。采用 Kaplan-Meier 法估计总生存期（OS）。同时，采用单因素和多因素 Cox 回归模型评估 OS 的危险因素。将 146.82 和 36.32U/ml 定义为高 PLR 和高 CA19-9 的截断值。此外，生存分析显示，PLR＞146.82 和 CA19-9＞36.32 U/ml 的患者预后比 PLR≤146.82 和 CA19-9≤36.32 U/ml 的患者差。多因素分析表明，PLR（风险比（HR）=1.863，95%CI：1.366-2.542，P＜0.001）和 CA19-9（HR=1.412，95%CI：1.021-1.952，P=0.037）是 GBC 患者的独立预后因素。当我们结合这两个参数时，ROC 曲线下面积从 PLR 的 0.624 和 CA19-9 的 0.661 增加到 0.711。此外，组 A（PLR≤146.82 和 CA19-9≤36.32 U/ml）、组 B（PLR＞146.82 或 CA19-9＞36.32 U/ml）和组 C（PLR＞146.82 和 CA19-9＞36.32 U/ml）的 1、3 和 5 年 OS 分别为 83.6%、58.6%、22.5%、52.4%、19.5%、11.5%和 42.3%、11.9%、0%。术前 PLR 和血清 CA19-9 与 GBC 患者的预后相关。PLR 和 CA19-9 的联合可作为 GBC 患者显著的预后生物标志物，优于单独的 PLR 或 CA19-9。
