治疗前血液检测指标对复发髓母细胞瘤患儿生存的预测价值及其危险因素分析

doi:10.12372/jcp.2024.23e0613

Abstract

Abstract:

Objective To investigate the relationship between peripheral blood platelet-lymphocyte ratio, prognostic nutritional index and prognosis in patients with medulloblastoma (MB) after recurrence and before re-treatment. Methods A retrospective study was conducted on 82 patients with MB admitted from September 2015 to September 2022. The post-recurrence OS rates were compared between high/low neutrophil-lymphocyte ratio (NLR) group, high/low platele-lymphocyte ratio (PLR) group, high/low systemic inflammation index (SII) group, and high/low prognostic nutritional index (PNI) group, and the prognostic factors were analyzed. Results The critical values of NLR, PLR, SII and PNI were 3.1, 311.7, 763.7 and 49.0, respectively. Univariate analysis suggested that high NLR, high PLR, high SII and low PNI were associated with shorter OS rate, and the differences between groups were statistically significant (P<0.05). COX regression analysis suggested that PLR was an independent risk factor and PNI was a protective factor for OS after recurrence (P<0.05). The risk of death in the high PLR group was 3.889 times that of the low PLR group, and the risk of death in the high PNI group was 0.484 times that of the low PNI group. Conclusions Relapse has a significant impact on the prognosis of children with MB. For children with recurrent MB, high PNI was a protective factor, but high PLR is a risk factor for a poor prognosis.

Key words: platelet count, lymphocyte count, prognostic nutritional index, medulloblastoma, recurrence

LIU Jingjing, LIU Lei, DU Shuxu, SUN Yanling, GONG Xiaojun, ZHANG Jin, WU Wanshui, SUN Liming. The survival predictive value of pre-treatment blood test indicators and risk factors for children with recurrent medulloblastoma[J].Journal of Clinical Pediatrics, 2024, 42(6): 538-542.

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References 18

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项目	存活组（n=28）	死亡组（n=54）	统计量	P
年龄[M(P₂₅~P₇₅)]/岁	8.40（3.30~15.40）	7.20（2.40~15.10）	t=1.47	0.142
性别[n(%)]			χ²=0.23	0.631
男	21（75.00%）	43（79.63%）
女	7（25.00%）	11（20.37%）
复发部位[n(%)]			χ²=0.60	0.740
头	9（32.14%）	21（38.89%）
脊髓	7（25.00%）	10（18.52%）
广泛播散	12（42.86%）	23（42.59%）
病理分型[n(%)]			χ²=2.09	0.214
CMB	19（67.86%）	28（51.85%）
DMB	8（28.57%）	18（33.33%）
LC/A	1（3.57%）	8（18.82%）
NLR[n(%)]			χ²=6.33	0.012
高	3（10.7%）	20（37%）
低	25（89.3%）	34（63%）
PLR[n(%)]			χ²=2.39	0.122
高	1（3.6%）	8（14.8%）
低	27（96.4%）	46（85.2%）
SII[n(%)]			χ²=6.88	0.009
高	1（3.6%）	15（27.8%）
低	27（96.4%）	39（72.2%）
PNI[n(%)]			χ²=9.11	0.003
高	24（85.7%）	28（51.9%）
低	4（14.3%）	26（48.1%）

项目	β	χ²值	P	RR	95%CI
NLR	0.906	3.377	0.066	2.475	0.942~6.507
PLR	1.358	8.826	0.003	3.889	1.587~9.528
SII	-0.518	0.941	0.332	0.596	0.209~1.697
PNI	0.725	5.177	0.023	0.484	0.260~0.904

项目	生存期<2年（n=53）	生存期≥2年（n=29）	χ²值	P
高PNI	29（54.71）	23（79.31）	4.89	0.027
低PNI	24（45.28）	6（20.69）	4.89	0.027
低PLR	44（83.02）	29（100）	5.53	0.019
高PLR	9（16.98）	0（0）	5.53	0.019

The survival predictive value of pre-treatment blood test indicators and risk factors for children with recurrent medulloblastoma

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