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术前淋巴细胞和嗜酸粒细胞水平对早期宫颈鳞状细胞癌患者预后的预测价值
作者:黄巧红  秦锦龙  吕冰峰 
单位:张家港市第二人民医院 妇产科, 江苏 张家港 215600
关键词:宫颈鳞状细胞癌 淋巴细胞 嗜酸粒细胞 预后 
分类号:R737.33
出版年·卷·期(页码):2020·48·第十一期(1404-1408)
摘要:

目的:探讨术前外周血淋巴细胞(LY)与嗜酸粒细胞(EO)水平对早期宫颈鳞状细胞癌(CSCC)患者预后的预测价值。方法:选取2014年1月至2015年1月在张家港市第二人民医院行"广泛子宫切除术+盆腔淋巴结清扫术"治疗的98例CSCC患者,随访开始于术后,截至于2020年1月,死亡27例。通过ROC曲线判断LY、单核细胞(MO)、中性粒细胞(NE)、EO与嗜碱粒细胞(BA)对CSCC患者预后的价值,将有统计学意义的指标LY、EO按预测界值对CSCC患者分别进行分组,比较组间临床病理特征及5年总体生存率,最后通过Cox比例风险回归模型进行多因素分析,判断影响CSCC患者预后的独立危险因素。结果:(1) LY、MO、NE、EO、BA的AUC分别为0.795、0.523、0.519、0.816、0.530,P值分别为<0.01、0.719、0.801、<0.01、0.690,LY、EO预测界值分别为1.350×109L-1、0.179×109L-1。(2)低LY组与高LY组CSCC患者临床分期、分化程度、淋巴结转移、间质浸润深度比较,差异均有统计学意义(P<0.05),而年龄、肿瘤大小、脉管浸润,差异无统计学意义(P>0.05);低EO组与高EO组患者临床分期、分化程度、淋巴结转移、间质浸润深度比较,差异均有统计学意义(P<0.05),而年龄、肿瘤大小、脉管浸润,差异无统计学意义(P>0.05)。(3)低LY组CSCC患者5年生存率显著低于高LY组(59.5%比80.3%,P <0.05);低EO组患者5年生存率显著高于高EO组(82.3%比55.6%,P <0.01)。(4) Cox多因素分析显示,LY、EO、FIGO分期及淋巴结转移均是影响CSCC患者术后生存的独立危险因素(P<0.05)。结论:术前LY、EO水平有望成为早期CSCC患者预后的有效预测指标,高LY可能提示预后良好,高EO可能提示预后不良。

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