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[1]侯 平,张俊榕.应用术前外周血NLR,dNLR,PLR及LMR预测梗阻性左半结肠癌患者预后[J].福建医科大学学报,2018,52(06):389-395407.
 HOU Ping,ZHANG Junrong.Preoperative Peripheral Blood NLR, dNLR, PLR and LMR in Prediction of Long-Term Survival for Obstructive Left-Side Colorectal Cancer[J].Journal of Fujian Medical University,2018,52(06):389-395407.
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应用术前外周血NLR,dNLR,PLR及LMR预测梗阻性左半结肠癌患者预后(PDF)
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《福建医科大学学报》[ISSN:1672-4194/CN:35-1192/R]

卷:
第52卷
期数:
2018年06期
页码:
389-395407
栏目:
临床研究
出版日期:
2018-12-20

文章信息/Info

Title:
Preoperative Peripheral Blood NLR, dNLR, PLR and LMR in Prediction of Long-Term Survival for Obstructive Left-Side Colorectal Cancer
文章编号:
1672-4194(2018)06-0389-08
作者:
侯 平1 张俊榕2
福建医科大学 1.免疫治疗研究所,福州 350122; 2.附属协和医院 急诊外科,福州 350001
Author(s):
HOU Ping 1 ZHANG Junrong 2
1. Immunotherapy Institute of Fujian Medical University, Fuzhou 350122, China; 2. Department of Emergency Surgery, Fujian Medical University Union Hospital, Fuzhou 350001, China
关键词:
肠梗阻/病因学 结肠肿瘤/并发症 结肠 生物学标记 炎症 金属 支架 预后
Keywords:
intestinal obstruction/etiology colonic neoplasms/complications colon biological markers inflammation metals stents prognosis
分类号:
R322.45; R735.35
DOI:
-
文献标志码:
A
摘要:
目的 探讨术前外周血中中性粒细胞/淋巴细胞比值(NLR)、间接中性粒细胞/淋巴细胞比值(dNLR)、血小板/淋巴细胞比值(PLR)、淋巴细胞/单核细胞比值(LMR)与急诊手术组(ES组)和肠道金属支架置入后择期手术组(SEMS组)的梗阻性左半结肠癌患者预后的关系,评估其对预后的预测价值。 方法 回顾性分析88例梗阻性左半结肠癌患者的临床病理资料和随访资料,采用Kaplan-Meier生存分析ES组和SEMS组3年无瘤生存率的差别,比较2组患者术前不同时期外周血中NLR,dNLR,PLR和LMR的比值,通过受试者工作特征曲线(ROC 曲线)确定NLR,dNLR,PLR和LMR预测3年无瘤生存率的最佳分界点及预测效能,并根据此节点将患者分为高比值组和低比值组。采用Kaplan-Meier生存分析,单因素及多因素Cox回归进一步分析影响2组梗阻性左半结肠癌患者预后的独立危险因素。 结果 SEMS组和ES组3年无瘤生存时间分别为(28.40±1.91),(27.82±1.88)月,差别无统计学意义(P>0.05)。SEMS组支架置入前患者外周血中NLR,PLR平均值明显高于SEMS组(P=0.046,P=0.042)。ES组术前患者外周血中NLR平均值明显高于SEMS组(P=0.015)。ES组术前外周血中NLR和dNLR能有效预测术后3年无瘤生存率,ROC曲线下面积(AUC)分别为0.570和0.632; 其中NLR的最佳分界点为19.57,dNLR的最佳分界点为1.58。ES组的CEA表达量(P=0.044)、肿瘤大小(P=0.013)和术前外周血NLR比值是影响术后3年无瘤生存率的危险因素。多因素分析发现,术前外周血中NLR≥19.57是影响ES患者术后3年无瘤生存率的独立危险因素(HR=7.412,95%CI=1.874~29.314)。SEMS组患者的肿瘤浸润深度是影响预后的独立危险因素(P=0.002,HR=10.837,95%CI=2.377~49.401)。 结论 术前外周血中NLR是影响ES梗阻性左半结肠癌患者预后的独立危险因素,而肿瘤浸润深度是影响SEMS梗阻性左半结肠癌患者预后的独立危险因素。
Abstract:
Objective To explore the role and efficacy of preoperative neutrophil-lymphocyte ratio(NLR), derived neutrophil-lymphocyte ratio(dNLR), platelet-lymphocyte ratio(PLR)and lymphocyte-monocyte ratio(LMR)in prediction of disease-free survival for obstructive left-side colorectal cancer patients who receive emergency surgery(ES)or self-expandable metal stent(SEMS)insertion followed with elective surgery. Methods The clinicopathological data and follow-up data of 88 patients with obstructive left colon cancer were analyzed retrospectively. The difference in the 3-year disease free survival rate between ES and SEMS was analyzed by Kaplan-Meier survival. The ratio of NLR, dNLR, PLR and LMR in the peripheral blood were compared between ES and SEMS group, and the optimal cut-off point was confirmed by receiver operating characteristic curve(ROC curve). Finally, the patients were divided into high ratio group and low ratio group according to the optimal cut-off point. Kaplan-Meier survival analysis, single factor and multiple factor Cox regression were used to further analyze the independent risk factors affecting the prognosis of ES and SEMS group with obstructive left-side colorectal cancer. Results The 3-year disease-free survival time of SEMS group was(28.40±1.91)months, while the 3-year disease-free survival time of ES group was(27.82±1.88)months(P>0.05). The mean values of NLR and PLR in the SEMS group before implantation were significantly higher than they were before surgery(P=0.046, P=0.042). The mean value of NLR in the ES group was significantly higher than that of SEMS group before surgery(P=0.015). The NLR and dNLR in peripheral blood of ES group could effectively predict the 3-year disease free survival(3-year DFS), the area under the ROC curve(AUC)were

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备注/Memo

备注/Memo:
收稿日期: 2018-06-14
基金项目: 福建医科大学启航基金(2017XQ1050)
作者单位: 福建医科大学 1.免疫治疗研究所,福州 350122; 2.附属协和医院 急诊外科,福州 350001
作者简介: 侯 平,女,助理实验师,理学硕士
通讯作者: 张俊榕. Email: foxbaby34@163.com
更新日期/Last Update: 2018-12-30