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目的:探讨上皮性卵巢癌（EOC）患者术前外周血单核细胞与淋巴细胞比值（MLR）联合纤维蛋白原（Fbg）检测对患者预后的预测价值。方法:连续纳入2014年1月至2017年1月在南京鼓楼医院高淳分院行手术治疗的EOC患者80例。通过受试者工作特征（ROC）曲线确定MLR、Fbg界值，然后进行分组。比较组间年龄、国际妇产科联盟（FIGO）分期、淋巴转移、静脉转移等指标；进行组间5年累积生存率分析；通过Cox比例风险回归模型进行多因素分析，判断影响EOC预后的独立危险因素。结果:根据ROC曲线，MLR预测界值为0.25，高MLR组（MLR ≥ 0.25，42例）较低MLR组（MLR<0.25，38例）具有较高的淋巴转移率和静脉转移率[33.3%（14/42）比13.2%（5/38）、33.3%（14/42）比10.5%（4/38）]，FIGO分期Ⅲ~Ⅳ期率也较高[66.7%（28/42）比18.4%（7/38）]，差异均有统计学意义（n P<0.05）。根据ROC曲线，Fbg浓度预测界值为3.15 g/L，高Fbg组（Fbg ≥ 3.15 g/L，37例）较低Fbg组（Fbg<3.15 g/L，43例）具有较高的淋巴转移率和静脉转移率[35.1%（13/37）比14.0%（6/43）、32.4%（12/37）比14.0%（6/43）]，FIGO分期Ⅲ~Ⅳ期率也较高[70.3%（26/37）比20.9%（9/43）]，差异均有统计学意义（n P<0.05）。基于Fbg、MLR临界值，将EOC患者分为三组：第一组：Fbg<3.15 g/L、MLR<0.25，27例；第二组：Fbg<3.15 g/L、MLR ≥ 0.25或Fbg ≥ 3.15 g/L、MLR<0.25，31例；第三组：Fbg ≥ 3.15 g/L、MLR ≥ 0.25，22例；三组FIGO分期Ⅲ~Ⅳ期率[7.4%（2/27）、48.4%（15/31）、81.8%（18/22）]、静脉转移率[7.4%（2/27）、19.4%（6/31）、45.5%（10/22）]、淋巴转移率[3.7%（1/27）、25.8%（8/31）、45.5%（10/22）]比较差异均有统计学意义（n P<0.01）。高MLR组5年累积生存率低于低MLR组（66.7%比89.5%），高Fbg组5年累积生存率低于低Fbg组（64.9%比88.4%），差异均有统计学意义（n P <0.05）。第一组、第二组及第三组的5年累积生存率分别为96.3%、77.4%和54.5%，差异有统计学意义（ n P<0.01）。Cox多因素分析显示MLR、Fbg、MLR联合Fbg是影响EOC患者术后生存的独立危险因素（n P<0.05）。n 结论:术前MLR与EOC患者的肿瘤进展和预后密切相关，可将其作为评估EOC患者预后的有效预测指标。“,”Objective:To investigate the prognostic value of peripheral blood monocyte to lymphocyte ratio (MLR) combined with fibrinogen (Fbg) in patients with epithelial ovarian cancer (EOC) before operation.Methods:Retrospectively included 80 patients with EOC who underwent surgical treatment at Gaochun Branch of Nanjing Drum Tower Hospital from January 2014 to January 2017. The boundary values of MLR and Fbg were determined by the receiver operating characteristic(ROC) curve, and then grouped by the critical value. The patients were evaluated with age, FIGO stage, lymphatic metastasis, and venous metastasis between groups. The 5-year cumulativesurvival rate was analyzed among the groups, and the independent risk factors influencing the prognosis of EOC were determined by Cox proportional risk regression model.Results:The predicted cut-off value of MLR was 0.25. Compared with the low MLR group (MLR<0.25, 38 cases), the high MLR group (MLR≥0.25, 42 cases) had a higher rate of lymphatic metastasis and venous metastasis: 33.3%(14/42) vs. 13.2%(5/38), 33.3%(14/42) vs. 10.5%(4/38); and the proportion of patients in stage Ⅲ to Ⅳwas also higher:66.7%(28/42) vs.18.4%(7/38), the differences were statistically significant (n P<0.05). The predicted cut-off value of Fbg concentration was 3.15 g/L. Compared with the low Fbg group (Fbg<3.15 g/L, 43 cases), the high Fbg group (Fbg≥3.15 g/L, 37 cases) had a higher rate of lymphatic metastasis and venous metastasis:35.1%(13/37) vs. 14.0%(6/43), 32.4%(12/37) vs. 14.0%(6/43); and the proportion of patients in stage Ⅲ to Ⅳ was also higher: 70.3%(26/37) vs. 20.9%(9/43), the differences were statistically significant (n P<0.05). At predicted cut-off value of MLR combined with Fbg, the patients were divided into the first group (Fbg<3.15 g/L, MLR<0.25, 27 cases), the second group (Fbg<3.15 g/L, MLR≥0.25 or Fbg≥3.15g/L, MLR<0.25, 31 cases) and the third group (Fbg≥3.15g/L,MLR≥0.25, 22 cases), there were statistically significant differences in the proportion of patients in stage Ⅲ to Ⅳ: 7.4%(2/27), 48.4%(15/31), 81.8%(18/22); venous metastasis: 7.4%(2/27), 19.4%(6/31), 45.5%(10/22); and lymphatic metastasis: 3.7% (1/27), 25.8%(8/31), 45.5%(10/22) among the three groups (n P<0.01). The 5-year cumulative survival rate of EOC patients in the high MLR group was significantly lower than that in the low MLR group:66.7% vs. 89.5%,n P<0.05. The 5-year cumulative survival rate of patients in the high Fbg group was significantly lower than that in the low Fbg group :64.9% vs. 88.4%,n P<0.05. The 5-year survival rates of EOC patients in the first, second and third groups were 96.3%, 77.4% and 54.5%, respectively, with significant differences among the three groups (n P<0.01). Cox multivariate analysis showed that MLR, Fbg and MLR combined with Fbg were independent risk factors for survival of EOC patients (n P<0.05).n Conclusions:Preoperative MLR combined with Fbg was closely related to the tumor progression and prognosis of EOC patients, and it could be used as an effective predictor of the prognosis of EOC patients.