| 郭信伟,杨睿,孙红娟,等.治疗前纤维蛋白原/前白蛋白比值和C-反应蛋白/淋巴细胞比值对胸段食管鳞癌放化疗疗效及预后的影响[J].中华放射医学与防护杂志,2026,46(3):256-263.Guo Xinwei,Yang Rui,Sun Hongjuan,et al.Impact of pretreatment fibrinogen-to-prealbumin ratio and C-reactive protein-to-lymphocyte ratio on the efficacy and prognosis of thoracic esophageal squamous cell carcinoma treated with radiotherapy or chemoradiotherapy[J].Chin J Radiol Med Prot,2026,46(3):256-263 |
| 治疗前纤维蛋白原/前白蛋白比值和C-反应蛋白/淋巴细胞比值对胸段食管鳞癌放化疗疗效及预后的影响 |
| Impact of pretreatment fibrinogen-to-prealbumin ratio and C-reactive protein-to-lymphocyte ratio on the efficacy and prognosis of thoracic esophageal squamous cell carcinoma treated with radiotherapy or chemoradiotherapy |
| 投稿时间：2025-02-23 |
| DOI：10.3760/cma.j.cn112271-20250223-00058 |
| 中文关键词: 食管鳞状细胞癌 纤维蛋白原与前白蛋白比值 C反应蛋白与淋巴细胞比值 放化疗 预后 |
| 英文关键词:Esophageal squamous cell carcinoma Fibrinogen-to-prealbumin ratio C-reactive protein-to-lymphocyte ratio Chemoradiotherapy Prognosis |
| 基金项目:江苏卫生健康职业学院校级科研项目(JKCY202420);泰州市社会发展项目(SSF20230012) |
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| 中文摘要: |
| 目的 探讨治疗前纤维蛋白原/前白蛋白比值(FPR)和C-反应蛋白/淋巴细胞比值 (CLR) 对胸段食管鳞癌接受放(化)疗患者治疗效果及生存预后的影响。方法 对2014年1月至2018年12月在泰兴市人民医院行根治性放疗或放化疗的150例胸段食管鳞癌患者进行回顾性分析,基于治疗前的FPR和CLR的中位值,将患者分为FPR≥0.195组76例和FPR＜0.195组74例,CLR≥4.294组75例和CLR＜4.294组75例。治疗效果采用logistic回归分析;生存预后采用Kaplan-Meier法计算无疾病进展生存 (PFS) 和总生存 (OS),并Log-rank法检验Cox模型多因素分析。结果 整个队列中的总体有效率为69.3％,其中在CLR≥4.294组和CLR＜4.294组中,有效率分别为49.3％和89.3％;而在FPR≥0.195组和FPR＜0.195组中,有效率分别为52.6％和86.5％。单因素logistic回归分析显示,食管鳞癌的治疗效果与肿瘤部位、T分期、N分期、TNM分期、治疗方法、FPR和CLR密切相关(HR=0.116~4.103,P<0.05)。多因素logistic回归分析显示,仅治疗方法、TNM 分期、FPR和 CLR 是疗效的独立危险因素(HR=0.197~1.173, P<0.05)。此外,单因素生存分析显示,肿瘤部位、T 期、N 期、TNM分 期、治疗方法、淋巴细胞、纤维蛋白原、前白蛋白、CRP、FPR 和 CLR 均与胸段食管鳞癌患者的PFS和OS显著相关 (HRPFS= 0.564~3.646,P＜0.05;HROS=0.439~4.581,P＜0.05)。多因素 Cox 比例风险回归模型分析显示,仅TNM 期、治疗方法、FPR和CLR是PFS的独立预后因素(HR=0.591~2.955,P＜0.05),也是 OS 的独立预后因素 (HR=0.429~3.929,P＜0.05)。受试者工作特征(ROC)曲线显示,CLR和FPR预测疗效的曲线下面积(AUC)分别为0.810和0.720,预测PFS的AUC分别为0.871和0.725,预测OS的AUC分别为0.871和0.752,提示CLR的预测价值优于FPR。结论 FPR 和 CLR 在预测胸段食管鳞癌接受放(化)疗患者近期疗效及生存预后方面具有重要价值。 |
| 英文摘要: |
| Objective To investigate the impact of pretreatment fibrinogen-to-prealbumin ratio (FPR) and C-reactive protein-to-lymphocyte ratio (CLR) on treatment efficacy and survival prognosis in patients with thoracic esophageal squamous cell carcinoma (ESCC) undergoing radiotherapy or chemoradiotherapy. Methods A retrospective analysis was conducted on 150 patients with thoracic ESCC who received radical radiotherapy or chemoradiotherapy at Taixing People’s Hospital between January 2014 and December 2018. Based on the medians of pretreatment FPR and CLR, patients were divided into the FPR≥0.195 group (n = 76) and the FPR<0.195 group (n = 74), as well as the CLR≥4.294 group (n = 75) and the CLR<4.294 group (n = 75). Treatment efficacy was analyzed using logistic regression. Survival prognosis was assessed using progression-free survival (PFS) and overall survival (OS) calculated with the Kaplan-Meier method. The log-rank test and multivariate analysis with the Cox proportional hazards model were performed. Results The overall response rate for the entire cohort was 69.3%. In the CLR groups, the response rates were 49.3% in the CLR≥4.294 group and 89.3% in the CLR<4.294 group. In the FPR groups, the response rates were 52.6% in the FPR≥0.195 group and 86.5% in the FPR<0.195 group. Univariate logistic regression analysis showed that treatment efficacy was significantly associated with tumor location, T stage, N stage, TNM stage, treatment modality, FPR, and CLR [hazard ratio (HR) = 0.116-4.103, P<0.05]. Multivariate logistic regression analysis revealed that treatment modality, TNM stage, FPR, and CLR were independent risk factors for treatment efficacy (HR = 0.197-1.173, P<0.05). Univariate survival analysis indicated that tumor location, T stage, N stage, TNM stage, treatment modality, lymphocyte count, fibrinogen level, prealbumin level, C-reactive protein level, FPR, and CLR were significantly associated with PFS and OS (HRPFS = 0.564-3.646, P<0.05; HROS = 0.439-4.581, P<0.05). Multivariate Cox proportional hazards regression analysis demonstrated that TNM stage, treatment modality, FPR, and CLR were independent prognostic factors for both PFS (HR = 0.591-2.955, P<0.05) and OS (HR = 0.429-3.929, P<0.05). Receiver operating characteristic (ROC) curve analysis showed that the area under the curve (AUC) for CLR and FPR was 0.810 and 0.720 for predicting treatment efficacy, 0.871 and 0.725 for predicting PFS, 0.871 and 0.752 for predicting OS, respectively, indicating that CLR had superior predictive value to FPR. Conclusions FPR and CLR are valuable predictors of short-term treatment efficacy and survival prognosis in patients with thoracic ESCC undergoing radiotherapy or chemoradiotherapy. |
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