%0 Journal Article
%T 儿童神经母细胞瘤切除术后的生存预测因素<br>Predictors of Survival after Resection of Children with Neuroblastoma
%A 姬铭
%A 张鹏
%A 朱谦
%A 郝希伟
%J Advances in Clinical Medicine
%P 8256-8265
%@ 2161-8720
%D 2022
%I Hans Publishing
%R 10.12677/ACM.2022.1291190
%X 目的：探究术前中性粒细胞与淋巴细胞的比值(neutrophil to lymphocyte ratio, NLR)和血清C反应蛋白(c-reactive protein, CRP)与白蛋白(albumin, ALB)的比值(CRP/ALB ratio, CAR)对儿童神经母细胞瘤切除术后预后的预测价值。方法：利用受试者工作特征(ROC)曲线用于确定连续变量CAR与NLR的最佳截断值。并将患者分为三组：低NLR与低CAR被定义为NLR-CAR 0，高NLR与高CAR被定义为NLR-CAR 2，低NLR与高CAR或者高NLR与低CAR定义为NLR-CAR 1。Kaplan-Meier方法和Log-rank方法用于生存分析。采用单变量与多变量Cox比例风险回归来确定NB患者预后的独立因素。结果：根据ROC曲线，NLR的最佳截断值为2.49，CAR的最佳截断值为0.035。Kaplan-Meier方法显示，高NLR (&gt;2.49)、高CAR (&gt;0.035)以及NLR-CAR 2具有较差的总体生存期(P &lt; 0.01)。单因素及多因素Cox回归分析显示，年龄(&gt;18个月)、INSS分期(III-IV)以及NLR-CAR 2 (高NLR和高CAR)是NB患者预后的独立的危险因素(P &lt; 0.05)。结论：NLR-CAR 2 (高NLR和高CAR)是NB患儿预后有价值的生物标志物。<br />
OBJECTIVE: To investigate the predictive value of preoperative neutrophil-to-lymphocyte ratio (NLR) and serum C-reactive protein to albumin ratio (CAR) on the prognosis after resection of neuroblas-toma in children. METHODS: Subject operating characteristic (ROC) curves were used to determine the optimal cut-off values for the continuous variable CAR versus NLR. And patients were divided into three groups: low NLR with low CAR was defined as NLR-CAR 0, high NLR with high CAR was de-fined as NLR-CAR 2, and low NLR with high CAR or high NLR with low CAR was defined as NLR-CAR 1. Kaplan-Meier method and Log-rank method were used for survival analysis. Univariate versus mul-tivariate Cox proportional risk regression was used to determine independent factors of prognosis in NB patients. RESULTS: According to the ROC curve, the optimal cut-off value for NLR was 2.49 and for CAR was 0.035. Kaplan-Meier method showed that high NLR (&gt;2.49), high CAR (&gt;0.035) and NLR-CAR 2 had poorer overall survival (P &lt; 0.01). Univariate and multifactorial Cox regression analysis showed that age (&gt;18 months), INSS stage (III-IV), and NLR-CAR 2 (high NLR and high CAR) were independent risk factors for the prognosis of NB patients (P &lt; 0.05). CONCLUSION: NLR-CAR 2 (high NLR and high CAR) is a valuable biomarker for the prognosis of children with NB.
%K 神经母细胞瘤，手术，儿童，预后<br>Neuroblastoma
%K Surgery
%K Children
%K Prognosis
%U http://www.hanspub.org/journal/PaperInformation.aspx?PaperID=55644