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一些炎症参数能否预测恶性胸腔积液患者的生存期?

Can some inflammatory parameters predict the survival of patients with malignant pleural effusion?

作者信息

Dilvin Ozkan Nur, Bas Aynur, Scheed Axel, Vogl Melanie, Bohanes Tomas, Stubenberger Elisabeth, Sayan Muhammet, Cuneyt Kurul Ismail, Bahil Ghanim, Celik Ali

机构信息

Department of Thoracic Surgery, Milas State Hospital, Muğla, Türkiye.

Department of Thoracic Surgery, Başakşehir Çam Sakura City Hospital, İstanbul, Türkiye.

出版信息

Turk Gogus Kalp Damar Cerrahisi Derg. 2024 Oct 30;32(4):445-452. doi: 10.5606/tgkdc.dergisi.2024.26905. eCollection 2024 Oct.

Abstract

BACKGROUND

This study aimed to investigate whether there is a correlation between some serum inflammatory markers and the survival of patients with malignant pleural effusions (MPEs).

METHODS

The prospective study included 125 patients (67 males, 58 females; median age: 62 years; range, 40 to 92 years) who underwent thoracentesis for pleural effusion between January 2020 and December 2021. An overall survival analysis was performed, and survival differences between the groups were investigated. The cutoff value of the inflammatory parameters associated with mortality was determined by receiver operating characteristic analysis.

RESULTS

Median survival after detection of MPE was six months, and three- and five-year overall survivals were 16% and 4%, respectively. There was a significant correlation between the ECOG (Eastern Cooperative Oncology Group) score of the patients and the median survival. Serum C-reactive protein (CRP), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), fluid albumin, and serum lactate dehydrogenase (LDH)-to-pleural LDH ratio and survival had a statistically significant relationship in receiver operating characteristic analysis. Threshold values were determined accordingly. Poor prognostic factors that were found to be statistically significant were high CRP (p=0.001), high NLR (p=0.001), high PLR (p=0.02), and high serum LDH-to-pleural LDH ratio (p=0.04).

CONCLUSION

Some serum inflammatory markers, including high CRP, high NLR, high PLR, and high serum LDH-to-pleural LDH ratio, can be a simple and inexpensive method in predicting prognosis in patients with MPE.

摘要

背景

本研究旨在调查某些血清炎症标志物与恶性胸腔积液(MPE)患者生存率之间是否存在相关性。

方法

这项前瞻性研究纳入了2020年1月至2021年12月期间因胸腔积液接受胸腔穿刺术的125例患者(67例男性,58例女性;中位年龄:62岁;范围40至92岁)。进行了总生存分析,并研究了各组之间的生存差异。通过受试者工作特征分析确定与死亡率相关的炎症参数的临界值。

结果

检测到MPE后的中位生存期为6个月,3年和5年总生存率分别为16%和4%。患者的东部肿瘤协作组(ECOG)评分与中位生存期之间存在显著相关性。在受试者工作特征分析中,血清C反应蛋白(CRP)、中性粒细胞与淋巴细胞比值(NLR)、血小板与淋巴细胞比值(PLR)、胸水白蛋白以及血清乳酸脱氢酶(LDH)与胸水LDH比值与生存具有统计学显著关系。相应地确定了阈值。发现具有统计学显著性的不良预后因素为高CRP(p=0.001)、高NLR(p=0.001)、高PLR(p=0.02)和高血清LDH与胸水LDH比值(p=0.04)。

结论

一些血清炎症标志物,包括高CRP、高NLR、高PLR和高血清LDH与胸水LDH比值,可作为预测MPE患者预后的一种简单且廉价的方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8168/11620533/c46d15b4ecf5/TJTCS-2024-32-4-445-452-F1.jpg

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