摘要
目的探索术前外周血中性粒细胞和淋巴细胞比值(NLR)在结直肠癌预后评价中的意义。方法回顾性分析2001年1月至2011年12月在我院接受手术治疗并有完整随访资料的结直肠癌患者636例。根据患者术前外周血NLR分成高NLR(>5)组和低NLR(≤5)组,分析比较其预后情况。Kaplan-Meier法进行总生存时间和无病生存时间分析,Log-rank检验比较各组的生存情况,Cox回归分析筛选结直肠癌的独立预后因素。结果高NLR者188例,占29.6%;低NLR者448例,占70.4%。高NLR组患者表现为更晚的T分期(P=0.005)、N分期(P=0.006)和TNM分期(P=0.004),更多的脉管癌栓(P=0.003);高NLR组患者接受辅助化疗的比例高(P=0.034)。高NLR组患者的5年生存率为54.9%,低NLR组患者的5年生存率为67%,存在显著性差异(P<0.001)。多因素分析显示分化程度(P<0.001)、术后TNM分期(P<0.001)、术前癌胚抗原(CEA)水平(P<0.001)、脉管癌栓(P<0.001)、辅助化疗(P=0.025)以及NLR(P=0.006)是结直肠癌的独立预后因素。结论 NLR是结直肠癌的独立预后因素,NLR>5的结直肠癌患者预后不良。
ObjectiveTo explore the prognostic significance of preoperative neutrophil-lymphocytes ratio （NLR） in patients with colorectal cancer.Methods Clinical and follow-up data of 636 patients with colorectal cancer undergoing curative surgery between January 2001 and December 2001 were retrospectively analyzed. All the patients were divided as high and low groups by the NLR with a cut-off value of 5. Kaplan-Meier method and Log-rank test was used to analyze and compare the overall survival and disease-free survival time. Cox regression was used to screen the independent prognostic factors for colorectal cancer.Results 188 patients （29.6%） had high NLR （more than 5） while 448 patients （70.4%） had low NLR （5 or less）. High NLR patients showed the more advanced T stage （P=0.005）, N （P=0.006） and TNM stage （P=0.004）, and more LVI （P=0.003）; high NLR patients were more likely to receive adjuvant chemotherapy （P=0.034）. The 5-year survival rate for patients with high NLR group was 54.9% and 67% in low NLR group, with significant difference （P〈0.001）. Multiple factors analysis showed that differentiation （P〈0.001）, TNM stage （P〈0.001）, preoperative CEA levels （P〈0.001）, LVI （P〈0.001）, adjuvant chemotherapy （P=0.025） and NLR （P=0.006） were independent prognostic factors for colorectal cancer.Conclusion NLR was independent prognostic factors for colorectal cancer. Patients with high NLR （〉5） had poor prognosis.
出处
《中华临床医师杂志（电子版）》
CAS
2016年第6期785-789,共5页
Chinese Journal of Clinicians(Electronic Edition)
