摘要
目的分析基于术前外周血中性粒细胞与淋巴细胞计数的比值(neutrophil-to-lymphocyte ratio,NLR)联合血小板与淋巴细胞计数的比值(platelet-to-lymphocyte ratio,PLR)的评分方法(NLR-PLR)对接受肝切除术治疗的肝细胞癌(HCC)病人预后的预测能力.方法回顾性分析上海东方肝胆外科医院454例接受根治性肝切除术的HCC病人临床资料.NLR-PLR评分范围为0-2分,其中NLR>2.357或PLR>8.311均判定为1分,两者均符合计2分,符合一项者为1分,均未达到者为0分.采用Log-rank检验比较术后1年、3年和5年的无瘤生存率(recurrencefreesurvival,RFS),Cox比例风险模型分析影响RFS的危险因素,受试者工作特性曲线下面积(area under curve,AUC)及灵敏度和特异度判断预测的准确性.结果NLR-PLR评分为0、1和2分者分别为116、131和207例,1年、3年和5年的无瘤生存率分别为86.4%、79.1%和66.5%;67.6%、42.9%和31.4%;60.1%,25.6%和16.9%(P<0.0001).Cox分析提示NLR-PLR评分(风险比:1.782,95%可信区间:1.518~2.093,P<0.001)是影响无瘤生存时长的独立危险因素.NLR-PLR评分预测5年无瘤生存状态的AUC为0.771,以1分为截断值,预测的灵敏度为0.880、特异度为0.545.结论采用术前NLR-PLR评分能够准确预测HCC病人接受肝切除术治疗的预后.
Objective To analyze the predictive performance of NLR-PLR score based on preoperative neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio in predicting the prognosis of patients who underwent hepatectomy for hepatocellular carcinoma(HCC).Methods Data on a cohort of 454 patients who underwent curative hepatectomy for HCC in the Eastern Hepatobiliary Surgery Hospital were retrospectively analyzed.The NLR-PLR scores of patients were assigned as 0,1,and 2 points.Patients with NLR>2.357 or PLR>8.311 was assigned as 1 point,2 points for patients who met both criteria,and 0 for patients who did not meet neitherof the criterion.Log-rank test was used to compare the cumulative 1-year,3-year,and 5-year recurrence free survival(RFS)rates among patients with different points.Cox proportional hazard model was used to analyze the risk factors forRFS.Area under curve(AUC),sensitivity and specificitywere used to assess the predictive accuracy.Results There were 116,131 and 207 patients with 0,1 and 2 points,respectively.The cumulative 1-year,3-year,and 5-year recurrence free survival rates among patients with different points were 86.4%,71.9%and 66.5%vs.67.6%,42.9%and 31.4%vs.60.1%,25.6%and 16.9%(P<0.0001).The NLR-PLR score was an independent risk factor for recurrence free survival(hazardratio:1.782,95%confidenceinterval:1.518-2.093,P<0.001).The predicted AUC of NLR-PLR score in predicting 5-year RFS statuswas 0.771.When 1 point was set as cutoff value,the predictive sensitivity and specificity were 0.880 and 0.545,respectively.Conclusion Preoperative NLR-PLR score couldaccurately predict the recurrence free survivalinpatients with resected HCC.
作者
邹怡然
陈秦俊杰
李俊
沈锋
ZOU Yi-ran;CHEN Qinjunjie;LI Jun(The Eastern Hepatobiliary Hospital,Shanghai 200438,China)
出处
《肝胆外科杂志》
2020年第2期91-95,156,共6页
Journal of Hepatobiliary Surgery
基金
国家自然科学基金(81772531)
上海市优秀学术/技术带头人计划(19XD1425000)
关键词
肝细胞癌
预后预测
中性粒细胞
淋巴细胞
血小板
hepatocellular carcinoma
prognosticprediction
neutrophil
lymphocyte
platelet
作者简介
通讯作者:李俊;通讯作者:沈锋
