Value of mean platelet volume-to-lymphocyte ratio in assessing the prognosis of elderly patients treated with radiotherapy for esophageal cancer
10.3760/cma.j.cn115355-20231027-00166
- VernacularTitle:平均血小板体积与淋巴细胞比值对老年食管癌放疗患者预后的评估价值
- Author:
Qunhuang GUO
1
;
Shouguo LI
;
Ruixiang GUO
;
Hui XU
Author Information
1. 厦门大学附属中山医院肿瘤放疗科，厦门 361004
- Keywords:
Esophageal neoplasms;
Aged;
Radiotherapy;
Mean platelet volume-to-lymphocyte ratio;
Prognosis
- From:
Cancer Research and Clinic
2024;36(5):371-375
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the value of mean platelet volume-to-lymphocyte ratio (MPVLR) in assessing the prognosis of elderly patients treated with radiotherapy for esophageal cancer.Methods:A retrospective case series study was conducted. The clinical data of 102 elderly esophageal cancer patients who received radiotherapy from September 2015 to September 2020 in Zhongshan Hospital Affiliated to Xiamen University were retrospectively analyzed. After admission, all patients were tested for serum mean platelet volume and lymphocyte levels by using a fully automated hematology analyzer, and MPVLR was calculated. The optimal cut-off value of MPVLR was determined based on the receiver operating characteristic (ROC) curve. The patients were grouped according to the optimal cut-off value of MPVLR, and clinicopathological characteristics of the two groups were compared. The Kaplan-Meier method was used to analyze the overall survival of patients after radiotherapy, and the multivariate Cox proportional risk model was used to analyze the factors affecting the overall survival of patients after radiotherapy.Results:The age of 102 patients was (77±3) years; there were 58 male cases, 44 female cases; 67 cases of middle and high differentiation, 35 cases of low differentiation; 65 cases of TNM stage Ⅰ-Ⅱ, 37 cases of stage Ⅲ-Ⅳ. ROC curve analysis showed that the area under the curve of MPVLR predicting the overall survival of esophageal cancer patients after radiotherapy was 0.905 (95% CI: 0.855-0.955). The optimal cut-off value of MPVLR was 5.442. All patients were divided into the low MPVLR group (MPVLR ≤ 5.442, 60 cases) and the high MPVLR group (MPVLR > 5.442, 42 cases) according to the optimal cut-off value of MPVLR. The proportion of patients with low differentiation and stage Ⅲ-Ⅳ in the high MPVLR group was higher than that in the low MPVLR group (all P < 0.001). The 3-year overall survival rate after radiotherapy in the high-MPVLR group was lower than that in the low-MPVLR group (23.81% vs. 51.67%), and the difference in the overall survival of both groups was statistically significant ( P < 0.05). The differences in the overall survival of elderly esophageal cancer patients with different differentiation and TNM staging after radiotherapy were statistically significant (all P < 0.05). Univariate Cox regression analysis showed that TNM stage Ⅲ-Ⅳ ( HR = 3.034, 95% CI: 1.805-5.101), low differentiation ( HR = 2.872, 95% CI: 1.791-4.606), and MPVLR > 5.442 ( HR = 3.789, 95% CI: 2.000-7.178) were independent risk factors for overall survival in elderly patients with esophageal cancer after radiotherapy (all P < 0.001). Conclusions:MPVLR before radiotherapy is closely related to the prognosis of elderly patients with esophageal cancer, and patients with MPVLR > 5.442 may have poorer overall survival after radiotherapy.
