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基于NLR、PLR、WLR、MLR的系统炎症标志物评分与结直肠癌患者术后生存时间的相关性 被引量:19

The Correlation Between SIMS Constructed by NLR,PLR,WLR,MLR in Peripheral Blood and Postoperative Survival Time of Colorectal Cancer Patients
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摘要 目的构建系统炎症标志物评分(systemic inflammatory marker score,SIMS)并验证其与结直肠癌(CRC)根治性切除术后患者生存时间的相关性。方法选取协和医院在2015年1月~2017年12月期间收治的行根治性切除术治疗的1474例结直肠癌患者。收集患者术前中性粒细胞与淋巴细胞比值(ratio of neutrophil to lymphocyte,NLR)、血小板与淋巴细胞比值(ratio of platelet to lymphocyte,PLR)、白细胞与淋巴细胞比值(ratio of white blood cell to lymphocyte,WLR)、单核细胞与淋巴细胞比值(ratio of monocyte to lymphocyte,MLR)及临床病理相关资料,并对患者进行生存随访。采用ROC曲线获得NLR、PLR、WLR、MLR最佳截断值并构建SIMS。单因素及多因素Cox风险比例模型分析SIMS的临床价值。结果所有患者术后均获得随访,平均随访时间(38.47±5.36)月(范围1~60个月)。NLR、PLR、WLR、MLR的AUC分别为0.598、0.580、0.605、0.626,最佳截断值分别为3.04、155.26、4.38、0.358。NLR>3.04、PLR>155.26、WLR>4.38、MLR>0.358患者的死亡率高于NLR≤3.04、PLR≤155.26、WLR≤4.38、MLR≤0.358患者(χ^(2)=42.244、14.919、43.945、46.869,均P<0.01);不同NLR、PLR、WLR、MLR分组间生存曲线比较存在差异(均P<0.05)。不同SIMS评分人群的生存曲线比较存在差异(Log-rank P<0.05)。SIMS-3分(HR:1.758,95%CI:1.174~2.631)、SIMS-4分(HR:2.004,95%CI:1.446~2.777)是结直肠癌患者死亡的独立危险因素(均P<0.05)。结论成功构建出SIMS且证实术前SIMS是结直肠癌患者一个较易获得且价格低廉的预后指标,对评估结直肠癌患者术后生存时间有潜在价值。 Objective To construct a systematic inflammatory marker score(SIMS),and to verify its correlation with the survival time of patients after radical resection of colorectal cancer(CRC).Methods In all,1474 patients with colorectal cancer who received radical resection in our hospital from January 2015 to December 2017 were selected.Ratio of neutrophils to lymphocytes(NLR),ratio of platelets to lymphocytes(PLR),ratio of white blood cell to lymphocyte(WLR),ratio of monocyte to lymphocyte(MLR)and other related clinical pathological data were collected before operation.Follow up investigation was conducted on the survival of the patients.The optimal truncation values of NLR,PLR,WLR and MLR were obtained by ROC curve and SIMS was constructed.Univariate and multivariate Cox risk ratio models were used to analyze the clinical value of SIMS.Results All patients were followed up after surgery,with an average follow-up time of(38.47±5.36)months(range from 1 to 60 months).The AUC of NLR,PLR,WLR and MLR were 0.598,0.580,0.605 and 0.626 respectively,and the best cut-off values were 3.04,155.26,4.38 and 0.358 respectively.The mortality rates of patients with NLR>3.04,PLR>155.26,WLR>4.38,MLR>0.358 were higher than that of patients with NLR≤3.04,PLR≤155.26,MLR≤0.358,WLR≤4.38(χ^(2)=42.244,14.919,43.945,46.869,all P<0.01).There were differences in survival curves among groups with different NLR,PLR,WLR and MLR(all P<0.05).The survival curves of patients with various SIMS scores were different(P<0.05).The SIMS-3 points(HR:1.758,95%CI:1.174-2.631)and SIMS-4 points(HR:2.004,95%CI:1.446-2.777)were independent risk factors for colorectal cancer death(all P<0.05).Conclusion In this study,SIMS was successfully constructed and was confirmed to be a relatively easy and inexpensive prognostic index for colorectal cancer patients.SIMS has the potential value for evaluating postoperative survival time of colorectal cancer patients.
作者 毛富巍 曹英豪 邓胜和 古俊楠 薛一凡 陶凯雄 王国斌 吴轲 蔡开琳 Mao Fuwei;Cao Yinghao;Deng Shenghe(Department of Gastrointestinal Surgery Union Hospital,Tongji Medical College,Huazhong University of Science and Technology Wuhan 430022,China)
出处 《华中科技大学学报(医学版)》 CAS CSCD 北大核心 2022年第2期229-234,共6页 Acta Medicinae Universitatis Scientiae et Technologiae Huazhong
基金 协和医院2020年自由创新预研基金资助项目(F016.02004.20001.023)。
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