术前血液学炎症指标对基底细胞癌复发风险的预测价值.

Objective To investigate the predictive value of preoperative blood inflammatory markers for the recurrence risk in patients with basal cell carcinoma (BCC). Methods A total of 225 patients with BCC were divided into the high-risk recurrence group (155 cases) and the low-risk recurrence group (70 cases). General information and preoperative hematological indicators were collected in the two groups of patients. The neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), systemic inflammation marker (SIM) and platelet-to-lymphocyte ratio (PLR) were calculated. Receiver operating characteristic (ROC) curves were used to determine the predictive value of hematological markers with statistically significant differences between the two groups for BCC recurrence and to establish optimal cutoff values. Univariate and multivariate Logistic regression analyses were conducted to identify factors influencing BCC recurrence. A multivariate Logistic regression model was established to predict the recurrence risk of BCC. Area under the curve (AUC) and the Hosmer-Lemeshow test were used to evaluate the prediction efficiency and goodness-of-fit of the model. Results ROC analysis identified that optimal cutoff values for LMR and SIM were 5.12 and 0.86, respectively. Univariate Logistic regression analysis showed that LMR, SIM, ulceration at the primary tumor site, UV exposure and tumor maximum diameter were factors influencing BCC recurrence. Multivariate Logistic regression revealed that SIM ≥ 0.86, tumor maximum diameter ≥ 2.0 cm and UV exposure were risk factors for BCC recurrence, while LMR ≥ 5.12 had a protective effect. The Logistic prediction model for BCC recurrence risk was Logit (P) = -1.598 - 1.517 × LMR + 1.323 × SIM + 2.406 × UV exposure + 3.465 × tumor maximum diameter, with good model fit (P = 0.725) and an AUC of 0.869 (95% CI: 0.822-0.917) for predicting BCC recurrence risk. Conclusion Monitoring preoperative LMR and SIM levels can assist in assessing the risk of recurrence in BCC patients and provide important guidance for clinical decision-making. [ABSTRACT FROM AUTHOR]