摘要
目的探讨结直肠癌围手术期患者预后营养指数(PNI)与免疫功能及预后的相关性。方法选取200例围手术期Ⅲ期结直肠癌患者作为观察对象,所有患者均进行血清白蛋白浓度、C反应蛋白(CRP)以及血常规检测,根据检测结果计算PNI,再根据PNI进行分组,将109例PNI≥49.22的患者设为高PNI组,91例PNI<49.22的患者设为低PNI组。比较高PNI组和低PNI组CRP水平、淋巴细胞与单核细胞比值(LMR)、中性粒细胞与淋巴细胞比值(NLR)、血小板/淋巴细胞比值(PLR)及总生存(OS)率、无病生存(DFS)率;分析PNI与CRP、LMR、NLR、PLR及OS率、DFS率的相关性。结果高PNI组的CRP(2.15±0.28)mg/L、NLR(1.63±0.46)以及PLR(132.87±4.25)均低于低PNI组的(4.23±0.41)mg/L、(2.37±0.27)、(149.59±7.36),LMR(4.73±0.57)高于低PNI组的(2.96±0.21),有统计学差异(P<0.05)。随访3年,高PNI组的DFS率、OS率分别为88.1%、96.3%,均高于低PNI组的75.8%、85.7%,有统计学差异(P<0.05)。结直肠癌患者PNI与CRP、NLR、PLR呈负相关(r=-0.313、-0.411、-0.601,P<0.05),与LMR呈正相关(r=0.423,P<0.05)。结直肠癌患者PNI与OS率、DFS率呈正相关(r=0.411、0.396,P<0.05)。结论Ⅲ期结直肠癌患者围手术期营养状况对于其免疫功能有显著影响,营养状况良好的患者免疫状况更好,术后炎症状况更接近健康个体,有助于改善Ⅲ期结直肠癌患者的预后。
Objective To explore the correlation of prognostic nutrition index(PNI)with immune function and prognosis in patients with colorectal cancer during the perioperative period.Methods 200 patients with stageⅢcolorectal cancer during the perioperative period were selected as observation subjects,and all patients were tested for serum albumin concentration,C-reactive protein(CRP),and blood routine,and PNI was calculated according to the test results,and then grouped according to PNI,and 109 patients with PNI≥49.22%were set up as the high PNI group,and 91 patients with PNI<49.22%were set up as the low PNI group.The levels of CRP,lymphocyte to monocyte ratio(LMR),neutrophil to lymphocyte ratio(NLR),platelet/lymphocyte ratio(PLR),overall survival(OS)rate and disease-free survival(DFS)rate were compared between the high PNI group and the low PNI group.The correlation of PNI with CRP,LMR,NLR,PLR,OS rate and DFS rate was analyzed.Results High PNI group had CRP of(2.15±0.28)mg/L,NLR of(1.63±0.46),and PLR of(132.87±4.25),which were lower than(4.23±0.41)mg/L,(2.37±0.27),and(149.59±7.36)in the low PNI group;LMR of(4.73±0.57)in the high PNI group was higher than(2.96±0.21)in the low PNI group;there was a statistical difference between the two groups(P<0.05).At 3 years of follow-up,the rates of DFS and OS in the high PNI group were 88.1%and 96.3%,which were higher than 75.8%and 85.7%in the low PNI group;there was a statistical difference(P<0.05).PNI in colorectal cancer patients was negatively correlated with CRP,NLR,and PLR(r=-0.313,-0.411,-0.601;P<0.05)and positively correlated with LMR(r=0.423,P<0.05).PNI was positively correlated with OS rate and DFS rate in colorectal cancer patients(r=0.411,0.396;P<0.05).Conclusion The perioperative nutritional status of patients with colorectal cancer has a significant impact on the immune function of patients with stageⅢcolorectal cancer.Patients with better nutritional status have better immune status,and the postoperative inflammatory status is more similar to that of heal
作者
徐元庆
于汉卿
晁远
XU Yuan-qing;YU Han-qing;CHAO Yuan(Huizhou Sixth People's Hospital,Huizhou 516211,China)
出处
《中国实用医药》
2024年第17期56-59,共4页
China Practical Medicine
关键词
结直肠癌
预后营养指数
免疫功能
围手术期
预后
Colorectal cancer
Prognostic nutrition index
Immune function
Perioperative period
Prognosis
