摘要
目的术前中性粒细胞与淋巴细胞计数比值(neutrophils lymphocyte count ratio,NLR)是系统炎症反应的标志,对某些肿瘤估计预后有价值,但在结直肠腺癌中研究较少。本研究探讨术前NLR对结直肠腺癌患者预后的影响。方法回顾性分析2012-11-01-2013-09-30郑州大学第一附属医院经术后病理确诊为结直肠腺癌的469例患者病例资料,以NLR第75百分位数2.84为临界点,分析其术前NLR水平以及各临床病理因素与生存预后的关系。结果术前NLR与性别(HR=0.568,P=0.016)、术前癌胚抗原(carcinoembryonic antigen,CEA)水平(HR=1.829,P=0.011)和肿瘤位置(HR=2.171,P=0.002)有关联,与分化程度、T分期、年龄、术前糖类抗原19-9(carbohydrate antigen 19-9,CAl9-9)水平、有无神经脉管侵犯、N分期和M分期无关联,P>0.05。术前不同NLR水平的结直肠癌患者预后差异有统计学意义(χ~2=5.052,P=0.025),术前NLR升高(HR=1.537,P=0.046)、术前CEA水平升高(HR=1.654,P=0.011)、右半结肠癌(HR=1.721,P=0.014)、淋巴结转移(HR=3.311,P<0.001)和远处转移(HR=7.705,P<0.001)是患者不良预后的独立危险因素。结论 NLR是一种易于检测且价格低廉的检测方式,有望作为评估结直肠腺癌患者预后的参考指标。
OBJECTIVE Preoperative neutrophil lymphocyte count ratio(NLR) is a marker of systemic inflammato- ry response and is valuable in predicting prognosis for some tumors,but few studies have been conducted incolorectal ade-nocarcinoma.This article aimed to investigate the influence of preoperative NLR for the prognosis of patients with colorec- tal adenocarcinoma.METHODS We collected data from 469 patients diagnosed with colorectal adenocarcinoma from the First Affiliated Hospital of Zhengzhou University from November 1st,2012 to September 30th,2013.Analysis of the rela-tionship between preoperative NLR level and clinicopathological factors and survival prognosis of patients with colorectal adenocarcinoma was conducted.RESULTS Preoperative NLR level was associated with gender(HR=0.568,P=0.016), preoperative carcinoembryonic antigen(CEA) level (HR=1.829,P=0.011),and tumor location (HR=2.171,P= 0.002) and had no relationship with differentiation,T stage,age,preoperative CA199 level,presence or absence of neuro- vascular invasion,N stage and Mstage(P>0.05).There was a difference in prognosis between patients with colorectal cancer of different NLR levels before surgery(χ^2=5.052,P<0.05).Preoperative NLR levels(HR=1.537,P=0.046), preoperativeCEAlevels(HR=1.654,P=0.011),right colon cancer(HR=1.721,P=0.014),lymph node metastasis (HR=3.311,P<0.001)and distant metastasis(HR=7.705,P<0.001)were independent risk factors for poorprogno-sis.CONCLUSION NLR is an easy and inexpensive detection method,which is expected to be used as a reference index to evaluate the prognosis of patients with colorectal adenocarcinoma.
作者
侯智俐
袁维堂
孙振强
王贵宪
HOU Zhi-li;YUAN Wei-tang;SUN Zhen-qiang;WANG Gui-xian(Department of Colorectal Surgery,First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,P.R.Chin)
出处
《中华肿瘤防治杂志》
CAS
北大核心
2019年第9期643-646,共4页
Chinese Journal of Cancer Prevention and Treatment
作者简介
第一作者:侯智俐,男,河南林州人,住院医师,主要从事结直肠癌发病学及治疗学方面的研究工作.Tel:86-371-67967142,E-mail:houzhili5678@163.com;通讯作者:袁维堂,男,河南睢县人,博士,主任医师,主要从事结直肠癌发病学及治疗学方面的研究工作.Tel:86-371-67967142,E-mail:yuanweitang@zzu.edu.cn.
