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| 术前外周血指标在口腔鳞状细胞癌术后1年不良临床结局中的预测价值 |
| Preoperative Peripheral Blood Markers as Predictors of 1-Year Postoperative Adverse Clinical Outcomes in Patients with Oral Squamous Cell Carcinoma |
| 投稿时间：2026-01-13 |
| DOI：10.3969/j.issn.1000-0399.2026.07.003 |
| 中文关键词: 口腔鳞状细胞癌 外周血指标 不良临床结局 纤维蛋白原 淋巴细胞与单核细胞比值 |
| 英文关键词: Oral squamous cell carcinoma Peripheral blood markers Adverse clinical outcomes Fibrinogen Lymphocyte-tomonocyte ratio |
| 基金项目:安徽省财政支持项目(编号:AHWJ2023A20133) |
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| 中文摘要: |
| 目的 探讨术前外周血凝血及炎症指标在口腔鳞状细胞癌（OSCC）患者术后1年不良临床结局中的预测价值。方法 回顾性分析2022年9月至2025年1月于安徽医科大学第一附属医院口腔颌面外科行根治性手术的151例OSCC患者临床资料，根据术后1年是否出现复发、转移或严重并发症等将其分为无事件组（n=99）和事件组（n=52）。采用单因素、多因素二元logistic回归分析筛选OSCC患者术后1年临床结局的影响因素，并通过受试者工作特征（ROC）曲线评估各影响因素的预测效能。结果 单因素分析结果显示，两组间纤维蛋白原（FIB）、中性粒细胞与淋巴细胞比值（NLR）、淋巴细胞与单核细胞比值（LMR）、全身免疫炎症指数（SII）及宿主指数（H-index）比较，差异有统计学意义（P<0.05）。多因素分析结果显示，FIB水平升高是这类患者不良临床结局的独立危险因素（OR=2.187,95%CI:1.153～4.148,P=0.017）,LMR水平升高是其独立保护因素（OR=0.654,95%CI:0.451～0.948,P=0.025）。ROC曲线分析结果显示，FIB(AUC=0.688,95%CI:0.598～0.778)、LMR(AUC=0.696,95%CI:0.609～0.783)联合检测的曲线下面积为0.736(95%CI:0.654～0.819)，优于FIB(Z=2.273,P=0.020)、LMR(Z=2.404,P=0.016)单独检测。结论 术前FIB与LMR是OSCC术后1年不良临床结局的独立影响因素，二者联合检测可提高预测效能。 |
| 英文摘要: |
| Objective To investigate whether preoperative peripheral blood coagulation and inflammatory markers can predict 1-year postoperative adverse clinical outcomes in patients with oral squamous cell carcinoma(OSCC). Methods The clinical data of 151 patients diagnosed with OSCC who received radical resection at the Department of Oral and Maxillofacial Surgery, the First Affiliated Hospital of Anhui Medical University between September 2022 and January 2025 were retrospectively reviewed. Patients were categorized into the event-free group(99 patients) and the event group(52 patients) based on the occurrence of postoperative recurrence, metastasis, severe complications or other adverse events within one year after surgery. Univariate and multivariate binary logistic regression analyses were adopted to identify independent predictors for 1-year postoperative adverse clinical outcomes. Receiver operating characteristic(ROC) curve analysis was conducted to evaluate the predictive performance of each identified marker. Results Univariate analysis indicated that fibrinogen(FIB), neutrophil-tolymphocyte ratio(NLR), lymphocyte-to-monocyte ratio(LMR), systemic immune-inflammation index(SII) and host index(H-index) were significantly associated with adverse postoperative outcomes(all P<0.05). Multivariate logistic regression revealed that elevated preoperative FIB was an independent predictor of adverse 1-year clinical outcomes(OR=2.187, 95% CI: 1.153～4.148, P=0.017), whereas higher LMR acted as an independent protective predictor(OR=0.654, 95% CI: 0.451～0.948, P=0.025). ROC curve analysis demonstrated that the AUC value was 0.688(95% CI: 0.598～0.778) for FIB and 0.696(95% CI: 0.609～0.783) for LMR. The combined panel of FIB and LMR yielded an AUC of 0.736(95% CI: 0.654～0.819), which is better than FIB(Z= 2.273, P= 0.020) and LMR(Z= 2.404, P= 0.016) when used alone for detection. Conclusion Preoperative FIB and LMR serve as independent predictors for 1-year postoperative adverse clinical outcomes in OSCC patients. Combined detection of these two peripheral blood markers can effectively improve predictive accuracy. |
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