术前外周血中性/淋巴细胞比值对肝癌患者预后的影响  

Preoperative Blood Nneutrophil-to-lymphocyte Ratio as an Independent Prognostic Predictor after Hepatectomy for Hepatocellular Carcinoma

作　　者：李坚[1] 潘海燕[1] 蔡潮农[1] 关晓东[1] 李培平[1] 谢玉妍[2] 张百萌[1] 

机构地区：[1]中山大学附属第五医院普外科,广东珠海519000 [2]中山大学附属第五医院病理科,广东珠海519000

出　　处：《中山大学学报（医学科学版）》2012年第3期394-397,共4页Journal of Sun Yat-Sen University:Medical Sciences

基　　金：珠海市科技局医药卫生重大项目(PB20081002)

摘　　要：【目的】评价肝癌患者术前外周血中性/淋巴细胞比值(NLR)对肝癌患者预后的影响及预测价值。【方法】回顾性分析中山大学附属第五医院82例肝癌行肝部分切除患者临床病理资料,根据患者术前外周静脉血NLR大小分为低NLR组(NLR<5)和高NLR组(NLR≥5),Log rank单因素分析两组患者临床病理因素与无瘤生存时间、总生存时间之间的关系,将有统计学意义的单因素导入Cox回归模型进行风险分析。【结果】所有患者1、3、5年总生存率分别为91.4%、66.5%、57.2%,其中高NLR组1、3、5年生存率分别为80.0%、51.9%、37.0%,低NLR组1、3、5年生存率分别为94.0%、69.7%、61.7%。差异有统计学意义(P=0.044)。1、3、5年无瘤生存率分别为87.4%、59.1%、49.7%,其中高NLR组1、3、5年无瘤生存率分别为80.0%、40.0%、26.7%,低1、3、5年NLR组生存率分别为89.1%、63.7%、55.3%。差异有统计学意义(P=0.031)。单因素分析显示术前AFP≥400μg/L、肿瘤最大径>5 cm、肿瘤数目>3个、NLR≥5、血管侵犯及切缘阳性是影响肝部分切除术后肝癌无瘤生存及总生存时间的危险因素,Cox回归分析提示术前NLR≥5、肿瘤数目>3个以及最大肿瘤直径>5 cm及切缘阳性是肝癌复发的独立危险因素(P<0.01)。【结论】术前高NLR是影响肝癌患者术后复发的单独危险因素,对肝癌患者的预后有预测价值。[Objective] To evaluate the impact of an elevated preoperative neutrophil-to-lymphocyte ratio （NLR） on outcome after hepatectomy for hepatocellular carcinoma （HCC） , and the value of the NLR as an independent prognostic predict marker. [Methods ] Clinical data of 82 HCC patients underwent radical hepatectomy were retrospectively analyzed. According to preoperative NLR, the patients were divided into the low NLR group （NLR 〈 5） and the high NLR group （NLR ~〉5）, respectively. Univariate analysis was performed to assess for a significant difference in clinicopathological characteristics that influenced overall and diseasefree survival after hepatectomy. A multivariate analysis was performed by Cox regression for variables significant on univariate analysis. The Kaplan-Meier method was used to assess the overall and disease-free survival rate. [Results] The total 1, 3, and 5-year overall survival rates were 91.4%, 66.5%, and 57.2%, respectively. The overall survival of high NLR group was significantly worse than the low NLR group （1, 3, and 5-year overall survival were 80.0%, 51.9%, and 37.0% vs 94.0%, 69.7%, and 61.7%, respectively; P = 0.044）. The total 1, 3, and 5-year disease-free survival rates were 87.4%, 59.1%, and 49.7%, respectively. The disease-free survival of high NLR group was significantly worse than the low NLR group （ 1,3, and 5-year overall survival were 80.0%, 40.0%, and 26.7% vs 89.1%, 63.7%, and 55.3%, respectively; P = 0.031）. Preoperative NLR ≥ 5, AFP ≥400 ug/L ,multiple tumors （〉3）, tumor size （〉5 cm）, vascular invasion and positive resection margin were all risk factors of poor overall and disease-free survival. Cox regression analysis revealed that NLR ≥ 5, multiple tumors ≥ 3）, tumor size ≥5 cm） and positive resection margin were independent predictors of poorer overall and disease-free survival. [ Conclusion] Preoperative NLR ≥ 5 was an independent adverse predictor of disease-free and overall survival for hepatocellular carcinoma afte

关 键 词：肝肿瘤 中性粒细胞/淋巴细胞比值 预后 无瘤生存率 

分 类 号：R735.7[医药卫生—肿瘤]