摘要
目的探讨预后营养指数(PNI)联合血小板与淋巴细胞比值(PLR)在结直肠癌预后评估中的应用价值。方法回顾性分析2019年2月—2020年12月在该院行手术治疗的208例结直肠癌患者,受试者工作曲线(ROC)明确PLR、PNI评估结直肠癌术后早期并发症发生风险的最佳分界点,将PLR>165.50、PNI>43.70者设为高表达组,PLR≤165.50、PNI≤43.70者设为低表达组,分析PLR与PNI检查预测结直肠癌预总生存期(OS)价值,分析PLR、PNI、PLR联合PNI值与结直肠癌患者预后关系。结果PLR预测结直肠癌预OS的AUC为0.788,敏感度为83.35%,特异度为76.01%,阈值为165.50;PNI预测结直肠癌预OS的AUC为0.664,敏感度为64.83%,特异度为61.08%,阈值为43.70,PNI≤43.70者OS为(50.21±2.14)个月,显著高于PNI>43.70者OS的(32.98±1.96)个月,差异有统计学意义(P<0.05);PNI≤43.70者DFS为(41.42±1.86)个月,显著高于PNI>43.70者DFS的(23.84±1.52)个月,差异有统计学意义(P<0.05)。PLR≤165.50者OS为(54.21±2.65)个月,显著高于PLR>165.50者OS的(32.00±2.01)个月,差异有统计学意义(P<0.05);PLR≤165.50者DFS为(50.62±3.05)个月,显著高于PLR>165.50者DFS的(21.20±1.42)个月,差异有统计学意义(P<0.05)。高PLR联合高PNI值者OS(50.64±2.84)个月,低PLR联合低PNI值者OS(28.90±1.76)个月,差异有统计学意义(P<0.05);高PLR联合高PNI值者DFS为(45.25±2.18)个月,显著高于低PLR联合低PNI者DFS的(16.94±1.24)个月,差异有统计学意义(P<0.05)。多因素分析显示:PLR、PNI、PLR联合PNI均是影响结直肠癌预后的高危因素(P<0.05)。结论PLR联合PNI与结直肠癌预后密切相关,两者联合检查可更好地预测结直肠癌预后。
Objective To explore the application value of prognostic nutritional index(PNI)combined with platelet-to-lymphocyte ratio(PLR)in the evaluation of the prognosis of colorectal cancer.Methods A retrospective analysis of 208 patients with colorectal cancer who underwent surgery in this hospital from February 2019 to December 2020.The receiver operating curve(ROC)defines the best cut-off point for PLR and PNI to assess the risk of early complications after colorectal cancer surgery.PLR>165.50 and PNI>43.70 were set as the high expression group,and those with PLR≤165.50 and PNI≤43.70 were set as the low expression group.Analyze the value of PLR and PNI in predicting OS of colorectal cancer.Analyze the relationship between PLR,PNI,PLR combined PNI value and the prognosis of patients with colorectal cancer.Results The AUC of PLR predicting OS for colorectal cancer was 0.788,the sensitivity was 83.35%,the specificity was 76.01%,and the threshold was 165.50.The AUC of PNI predicting OS for colorectal cancer was 0.664,the sensitivity was 64.83%,the specificity was 61.08%,and the threshold is 43.70.The overall survival(OS)of PNI≤43.70 was(50.21±2.14)months,which was significantly higher than the OS of PNI>43.70(32.98±1.96)months,the difference was statistically significant(P<0.05).The DFS of those with PNI≤43.70 was(41.42±1.86)months,which was significantly higher than the(23.84±1.52)months of DFS with PNI>43.70,and the difference was statistically significant(P<0.05).The OS of patients with PLR≤165.50 was(54.21±2.65)months,which was significantly higher than the OS of patients with PLR>165.50(32.00±2.01)months,and the difference was statistically significant(P<0.05).The DFS of patients with PLR≤165.50 was(50.62±3.05)months,which was significantly higher than that of DFS patients with PLR>165.50(21.20±1.42)months,and the difference was statistically significant(P<0.05).The OS with high PLR combined with high PNI was(50.64±2.84)months,and the OS with low PLR combined with low PNI was(28.90±1.76)months,the difference was statistically significant(P<0.05).The DFS of patients with high PLR combined with high PNI was(45.25±2.18)months,which was significantly higher than that of DFS with low PLR combined with low PNI(16.94±1.24)months,and the difference was statistically significant(P<0.05).Multivariate analysis showed that PLR,PNI,PLR combined with PNI were all high-risk factors affecting the prognosis of colorectal cancer(P<0.05).Conclusion The combination of PLR and PNI is closely related to the prognosis of colorectal cancer,and the combined examination of the two can better predict the prognosis of colorectal cancer.
作者
林燕飞
LIN Yanfei(Department of General Surgery,Xiamen Hospital,Zhongshan Hospital,Fudan University,Xiamen,Fujian Province,361006 China)
出处
《中外医疗》
2021年第32期79-83,共5页
China & Foreign Medical Treatment
关键词
结直肠癌
PNI
早期并发症
PLR
炎症状态
营养指标
免疫状态
Colorectal cancer
PNI
Early complications
PLR
Inflammatory status
Nutritional indicators
Immune status
作者简介
林燕飞(1989-),男,硕士,住院医师,研究方向为普外科,胃肠、胆道等。
