胃癌患者血小板参数对肿瘤转移的预测价值初探

摘要

目的 探讨胃癌患者血小板参数对肿瘤转移的预测价值.方法 回顾性分析2008年7月至2011年12月就诊于在邯郸市第一医院经病理组织学检查证实的原发胃癌患者.将入选患者分为转移组(n=86)和非转移组(n=131).分析两组患者基本临床资料、病理分型和肿瘤胃壁浸润情况,记录两组患者外周静脉血血小板计数(PLT)、平均血小板体积(MPV)、血小板分布宽度(PDW)以及血小板压积(PCT)等血小板参数.结果 两组患者性别、年龄以及病理分型相似.与非转移组比较,转移组患者PLT、MPV、PDW、PCT均较高,PLT(301.38±64.30)×109/L vs (262.48±53.59)×109/L;MPV(12.24±1.15) fl vs (10.17±0.82) fl;PDW(23.26±3.19)％ vs (21.95±2.70)％；PCT(0.38±0.07)％ vs (0.31±0.06)％(P＜0.01).将应变量肿瘤转移和自变量PLT、MPV、PDW和PCT进行赋值,逐步前进法进行logistic回归,建立肿瘤转移预报概率模型Log(P) =4.340-0.818PLT-4.478MPV-0.581PDW-3.015PCT,敏感度和特异度分别为0.840和0.942.结论 在检测血小板参数基础上建立预测模型,对胃癌患者肿瘤转移具有良好预测价值.%Objective To investigate the predictive effect of platelet parameters on tumor metastasis in patients with gastric carcinoma.Methods Consecutive patients who suffered from gastric carcinoma and got confirmation in our hospital in July 2008 to December 2011 were retrospectively enrolled.According to the occurrence of tumor metastasis, all the cases were divided into metastasis group( n =86) and non-metastasis group( n =131).The platelet count (PLT).mean platelet volume (MPV), platelet distribution width (PDW) and plateletocrit(PCT) were analyzed.The multi-variants logistics regression analysis and ROC curve were used to identify predictive effect of platelet parameters on tumor metastasis.Results Gender,age and pathological type were similar between two groups.The value of PLT, MPV,PDW and PCT were much higher in metastasis group than those in non-metastasis group,PLTC301.38±64.30) ×109/L vs (262.48±53.59)×109/L;MPV(12.24±l.15) fl vs (10.17±0.82) fl,PDW(23.26±3.19)% vs (21.95±2.70)%;PCT(0.38±0.07)% vs (0.31±0.06) %( P <0.01).The predictive model for tumor metastasis was Log (P) =4.340-0.818PLT-4.478MPV-0.581PDW-3.015PCT.At a cut-off point of 0.651,the value of predict model exhibited 84.0% sensitivity and 94.2% specificity for detecting tumor metastasis in patients with gastric carcinoma.Conclusion The value of predictive model based on platelet parameters can predict tumor metastasis in patients with gastric carcinoma with high sensitivity and specificity.