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目的探讨去势抵抗性前列腺癌(CRPC)患者氩氦冷冻消融术前外周血中性粒细胞与淋巴细胞比值(NLR)变化的意义。方法收集并分析天津医科大学肿瘤医院33例行氩氦冷冻消融术的CRPC患者的临床病理资料。将可能影响术后总生存期(OS)的因素:年龄、基线前列腺特异抗原(PSA)水平、血红蛋白、白细胞计数、血小板计数、白蛋白、碱性磷酸酶、NLR、血小板与淋巴细胞比值(PLR)、激素敏感时间、是否化疗、有无骨转移、Gleason评分、ECOG评分、PSA有效率进行单因素和多因素分析。结果本研究共33例患者,平均年龄为69岁(50~82岁),中位生存期为28个月(6~55个月),单因素分析显示:基线PSA水平、碱性磷酸酶、NLR、激素敏感时间、是否化疗、有无骨转移、Gleason评分、PSA有效率是影响CRPC患者冷冻消融术后OS的相关因素(P<0.05)。多因素分析显示:基线PSA水平(P=0.003)、NLR(P=0.009)、Gleason评分(P<0.001)是CRPC患者冷冻消融术后OS的独立预测因子。结论 NLR可作为CRPC患者行氩氦冷冻消融术的预后指标,NLR升高提示患者预后不良。
Objective To investigate the significance of the change of neutrophil to lymphocyte ratio (NLR) in patients with castrate resistant prostate cancer (CRPC) before argon-helium cryoablation. Methods Clinicopathological data of 33 patients with CRPC who underwent argon-helium cryoablation were collected and analyzed in Tumor Hospital of Tianjin Medical University. Factors that may affect overall postoperative survival (OS) were age, baseline PSA, hemoglobin, white blood cell count, platelet count, albumin, alkaline phosphatase, NLR, platelet to lymphocyte ratio ), Hormone sensitivity time, whether chemotherapy, bone metastasis, Gleason score, ECOG score, PSA effective rate of single factor and multivariate analysis. RESULTS: A total of 33 patients (mean age 69 years (range 50-82 years)) with a median survival of 28 months (range 6-55 months) were included in this study. Univariate analysis showed that baseline PSA level, alkaline phosphatase, NLR, hormone-sensitive time, chemotherapy, bone metastasis, Gleason score and PSA effective rate were related factors of OS in CRPC patients after cryoablation (P <0.05). Multivariate analysis showed that baseline PSA level (P = 0.003), NLR (P = 0.009), Gleason score (P <0.001) were independent predictors of OS after cryoablation in patients with CRPC. Conclusion NLR can be used as a prognostic indicator for cryogenic argon-helium cryoablation in patients with CRPC. Elevated NLR indicates a poor prognosis.