摘要
目的:探讨M0期结肠癌(colon cancer,CC)患者术前外周血淋巴细胞与单核细胞比值(lymphocyte-to-monocyte ratio,LMR)、中性粒细胞与淋巴细胞比值(neutrophil-to-lymphocyte ratio,NLR)、血小板与淋巴细胞比值(platelet-to-lymphocyte ratio,PLR)与术后淋巴结转移的关系,并建立指数预测模型。方法:回顾性分析我院2017年1月至2019年12月期间行根治性手术切除的M0期(术前影像学诊断)CC患者218例,根据术后病理诊断分为存在淋巴结转移组(pN+组)和无淋巴结转移组(pN0组),比较两组患者LMR、NLR、PLR值的差异及不同LMR、NLR、PLR水平与淋巴结分期、淋巴结转移数等的关系,利用多因素Logistic回归模型筛选M0期CC患者淋巴结转移的独立影响因素,并构建指数预测模型。结果:术后病理证实存在淋巴结转移组(pN+组)CC患者的术前中性粒细胞计数、血小板计数、C反应蛋白水平及NLR、PLR值明显高于无淋巴结转移组(pN0组)患者,pN+组的单核细胞计数、LMR则低于pN0组,差异均有统计学意义(均P<0.05)。不同术前LMR、NLR、PLR水平CC患者的淋巴结分期构成之间存在差异(均P<0.05),术前低LMR组的淋巴结转移数量高于术前高LMR组,差异具有统计学意义(P<0.05)。多因素Logistic回归分析显示,肿瘤大小、浸润深度、LMR、NLR是术前诊断为M0期CC患者术后淋巴结转移的独立影响因素,OR值分别为1.576、6.299、0.646和1.516。术前诊断为M0期CC患者术后淋巴结转移的风险函数模型为:h(t)=h0exp(1.576X_(1)+6.299X_(2)+0.646X_(3)+1.516X_(4))。结论:术前LMR、NLR、PLR水平与CC患者淋巴结分期状态密切相关,术前LMR、NLR是M0期CC患者术后淋巴结转移的独立影响因素,拟合的指数预测模型能较准确地预测M0期CC患者的淋巴结转移风险。
Objective:To investigate the relations of preoperative lymphocyte-to-monocyte ratio(LMR),neutrophil-to-lymphocyte ratio(NLR)and platelet-to-lymphocyte ratio(PLR)to postoperative lymph node metastasis in patients with M0 colon cancer,and establish an index prediction model.Methods:A retrospective analysis was made for 218 cases of colon cancer in M0 stage(preoperative imaging diagnosis)who underwent radical resection from January 2017 to December 2019 in our hospital.According to postoperative pathological diagnosis,they were assigned to the lymph node metastasis group(group pN+)and the non-lymph node metastasis group(group pN0).Differences in LMR,NLR,PLR values between the two groups were compared,and the relations of different LMR,NLR,PLR levels to lymph node stage and number of lymph node metastases were analyzed.Multivariate logistic regression model was used to screen the independent factors affecting lymph node metastasis in patients with M0 stage colon cancer,and an index prediction model was constructed.Results:The preoperative neutrophil count,platelet count,C-reactive protein level,NLR and PLR values of colon cancer patients in group pN+were significantly higher than those in group pN0,while the monocyte count and LMR in group pN+were lower than those in group pN0(all P<0.05).The lymph node stage composition of colon cancer patients with different preoperative LMR,NLR,and PLR levels was different(all P<0.05).The number of lymph node metastases in the low preoperative LMR group was significantly higher than that in the high preoperative LMR group(P<0.05).Multivariate logistic regression analysis showed that tumor size,depth of invasion,LMR and NLR were independent influencing factors for postoperative lymph node metastasis in preoperatively diagnosed M0 stage colon cancer patients,with OR values of 1.576,6.299,0.646 and 1.516,respectively.The risk function model of postoperative lymph node metastasis in preoperatively diagnosed M0 stage colon cancer patients is as follows:h(t)=h_0exp(1.576X_(1)+6.299X_(2)
作者
曹万龙
李由
韩华
马勇
吴红
钟仕江
冷蔚
Cao Wanlong;Li You;Han Hua;Ma Yong;Wu Hong;Zhong Shijiang;Leng Wei(Department of General Surgery,Zigong First People's Hospital,Zigong 643000,Sichuan,China)
出处
《肿瘤预防与治疗》
2023年第4期304-310,共7页
Journal of Cancer Control And Treatment
基金
自贡市重点科技计划项目(编号:2020YL SF15)。
