| Popis: |
Objective: Systemic inflammatory response and nutritional status are not only closely correlated to the occurrence and development of tumors, but also have become recognized indicators of cancer prediction. To explore the impact of lymphocyte-to-C-reactive protein ratio (LCR) and albumin to alkaline phosphatase ratio (AAPR) on the survival of the patients with osteosarcoma, this study was conducted. Methods: This study retrospectively analysed 81 osteosarcoma patients who received surgical treatment in the First Affiliated Hospital of Guangxi Medical University from 2014-2020. Clinical data and auxiliary examination results of enrolled patients were collected. LCR, AAPR, neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) are calculated from the preoperative peripheral blood leukocytes, C-reactive protein (CRP), alkaline phosphatase (ALP) and albumin (ALB). The optimal cut-off values of LCR, AAPR, NLR and PLR were determined by receiver operating characteristic curve (ROC), and which were divided into high and low groups according to the truncation values. The Kaplan-Meier method was conducted to plot the survival curve, and the influence of various factors on the prognosis of osteosarcoma was analyzed by univariate and multivariate survival analyses. Results: The optimal cut-off values of LCR, AAPR, NLR and PLR were 0.09, 0.26, 1.23 and 157.03 respectively. The number of patients with preoperative metastasis in the low LCR (LLCR) group was more than that in the high LCR (HLCR) group, while the Enneking stage of the HLCR group was mostly in stage I+II. In the low AAPR (LAAPR) group, most of the patients with mean age ≥17 years, and the number of patients with metastases were more than those in the high AAPR group. In addition, the majority of patients in the LAAPR group underwent tumor resection. In the low PLR (LPLR) group, tumors mostly occurred in the extremities, and most of the patients in the LPLR group did not have tumor metastasis before the operation. Univariate analysis showed that OS was significantly related to Enneking stage, metastasis, preoperative LCR, AAPR, NLR, and PLR (PP = 0.008), AAPR (HR, 0.464; 95% CI, 0.221 to 0.974; P = 0.042) and Enneking stage (HR, 3.058; 95% CI, 1.209 to 7.737; P = 0.018) was an independent prognostic factor affecting postoperative OS of osteosarcoma. Conclusion: This study provides new proofs that the preoperative LCR, AAPR and Enneking stage could act as vital prognostic parameters in patients with osteosarcoma. |
