【摘要】 目的:探讨术前血液中血小板、单核细胞、中性粒细胞与淋巴细胞的比值指标与早期恶性黑色素瘤(malignant melanoma,MM)患者临床病理特征及预后的相关性。方法:收集2007年1月到2012年5月在天津医科大学肿瘤医院初治并接受根治术的120例Ⅰ~Ⅲ期皮肤MM患者的临床资料,分析术前血液中血小板和淋巴细胞比值(platelet-to-lymphocyte ratio,PLR)、淋巴细胞和单核细胞比值(lymphocyte-to-monocyte ratio,LMR)、中性粒细胞和淋巴细胞比值(neutrophil-to-lymphocyte,NLR),以及血红蛋白、中性粒细胞、淋巴细胞、单核细胞、嗜酸性粒细胞、嗜碱性粒细胞、血小板、乳酸脱氢酶、年龄、肿瘤分期和溃疡等与MM患者临床病理特征及预后的关系。结果:原发病灶有溃疡患者的NLR及嗜碱性粒细胞较高(均P<0.05)。单因素分析结果显示PLR、NLR、LMR、中性粒细胞数、淋巴细胞数、单核细胞数、乳酸脱氢酶水平、年龄、肿瘤分期和溃疡是MM患者5年生存率的影响因素(P<0.05)。多因素分析结果发现,PLR(HR=4.206,95%CI:1.654~10.696,P<0.01)、肿瘤分期(HR=7.670,95%CI:3.977~14.795,P<0.01)和溃疡(HR=1.931,95%CI:1.029~3.623,P<0.05)是影响MM患者预后的独立危险因素。结论:术前高PLR可以作为早期MM患者不良预后的判断因素。更多还原

【Abstract】 Objective: To explore the relationship between the preoperative blood indicators(platelets, monocytes, neutrophils-to-lymphocyte ratio) and clinicopathological characters and the prognosis of the early stage malignant melanoma(MM)patients. Methods:Clinicopathological data of 120 cases of stage I-III MM patients, who received initial treatment and radical operation in the Cancer Hospital of Tianjin Medical University from January 2007 to May 2012, were obtained for this study. The correlations between parameters of PLR(platelet-to-lymphocyte ratio), LMR(lymphocyte-to-monocyte ratio), NLR(neutrophil-to-lymphocyte ratio), hemoglobin, neutrophils, lymphocytes, monocytes, eosinophils, basophils, platelets, lactate dehydrogenase, age, stage as well as ulcer and the prognosis of the patients were evaluated. Results: Patients whose tumor with ulceration have higher NLR and basophilic granulocyte(all P<0.05). Univariate analysis showed that NLR, PLR, LMR, neutrophil, lymphocyte, monocyte, lactic dehydrogenase, age, stage and ulceration were the risk factors of poor 5-year overall survival(P<0.05). The multivariate analysis identified PLR(HR=4.206,95%CI:1.654-10.696,P<0.01),stage(HR=7.670,95%CI:3.977-14.795,P<0.01)and ulceration(HR=1.931,95%CI:1.029-3.623,P<0.05)as independent risk factors for the prognosis of the MM patients. Conclusion: Higher preoperative PLR can be used as a predictive factor for poor prognosis of the early stage MM patients.更多还原