摘要
目的探讨患者术前中性淋巴细胞比率(NLR)、门冬氨酸氨基转移酶血小板比率(APRI)与临床病理特征及预后的关系。方法回顾性分析行肝细胞肝癌切除术的263例患者的临床资料,应用X-Tile软件确定NLR、APRI的最佳截断值,分析NLR、APRI与患者临床病理特征及预后的关系。结果 NLR、APRI的最佳截断值分别为2.4、0.3。术前NLR≥2.4患者与NLR<2.4患者相比,肝脏破裂出血风险较大、肿瘤较大、肿瘤数量较多(均P<0.05),术前APRI<0.3患者与APRI≥0.3患者相比,血管侵犯与肝硬化发生率、AFP水平较高(均P<0.05)。NLR<2.4且APRI≥0.3患者1、3、5年无瘤生存率与总生存率>NLR≥2.4且APRI≥0.3或NLR<2.4且APRI<0.3患者>NLR≥2.4且APRI<0.3患者(均P<0.05)。结论术前高NLR、低APRI肝细胞肝癌患者术后生存时间较短,预后较差。
Objective To investigate the correlation of preoperative neutrophil-to-lymphocyte ratio(NLR) and aspartate aminotransferase/platelet count ratio index( APRI) with clinicopathological characteristics and prognosis of patients with hepatocellular carcinoma(HCC). Methods Clinical Data of 263 patients with HCC who underwent curative resection were retrospectively analyzed. The optimal cut-off points of preoperative NLR and APRI to predict the postoperative survival of patients were determined by X-TILE software. The correlation of preoperative NLR, APRI with clinicopathological characteristics and prognosis of patients was analyzed. Results The optimal cut-off points of preoperative NLR, APRI to predict the postoperative survival of HCC patients were 2.4 and 0.3, respectively. Patients with preoperative NLR ≥2.4 had a higher risk of liver rupture and hemorrhage, a larger tumor and more malignant lesions than patients with NLR <2.4(all P <0.05). Patients with preoperative APRI <0.3 had a higher incidence of vascular invasion and cirrhosis and a higher AFP level than patients with APRI ≥0.3(all P<0.05). The 1-year, 3-year and 5-year disease-free survival rates and the overall survival rates were the highest in HCC patients with preoperative NLR≥2.4 and APRI<0.3/NLR<2.4 and APRI<0.3,while those in patients with NLR≥2.4 and APRI<0.3 were lowest. Conclusion Higher levels of preoperative NLR or lower levels of preoperative APRI predict shorter survival time and poorer outcomes in HCC patients.
作者
郑玉芬
杜菊萍
颜海希
吴春龙
李俊
陈世勇
沈波
ZHENG Yufen;DU Juping;YAN Haixi(Clinical Laboratory, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Taizhou 317000, China)
出处
《浙江医学》
CAS
2018年第24期2651-2656,共6页
Zhejiang Medical Journal
关键词
中性淋巴细胞比率
天门冬氨酸氨基转移酶血小板比率
肝细胞肝癌
预后
Neutrophil to lymphocyte ratio
Aspartate aminotransferase/platelet count ratio index
Hepatocellular carcinoma Prognosis
