NLR对肝癌TACE患者预后影响的分析  

Blood neutrophil-to-lymphocyte ratio predicts survival in patients with unresectable hepatocellular carcinoma undergoing transarterial chemoembolization

作　　者：李金鹏[1,2] 胡善亮[3,2] 陈华[1,2] 卜文哲[1,2] 宋金龙[1] 

机构地区：[1]山东省医学科学院山东省肿瘤医院外九科,山东济南250117 [2]济南大学.山东省医学科学院医学与生命科学学院,山东济南250000 [3]山东省医学科学院山东省肿瘤医院放疗科,山东济南250117

出　　处：《中华肿瘤防治杂志》2013年第7期522-525,共4页Chinese Journal of Cancer Prevention and Treatment

摘　　要：目的:评价不能手术切除的肝癌患者肝动脉化疗栓塞术(TACE)前后外周血中性粒细胞与淋巴细胞比值(NLR)对生存期的影响。方法:分析本院2006-02-2009-02 154例TACE治疗的肝癌患者临床资料,单因素分析年龄、性别、肝功能、乙肝抗原阳性、肿瘤直径、血管侵犯、肝外转移、甲胎蛋白水平、NLR以及术后患者NLR下降等对生存期的影响,对有统计学意义的术前单因素行Cox回归模型多因素分析。结果:TACE治疗前患者NLR的平均值为2.5,其中NLR≥2.5(69例)和NLR<2.5(85例)患者中位生存期分别为8和13个月,两组患者的总生存期差异有统计学意义(P=0.003)。单因素分析显示,年龄≥50岁、术前高水平的NLR、术后NLR水平下降、肿瘤直径≥5cm、血管侵犯和甲胎蛋白水平升高与短的生存期相关。Cox回归分析显示,术前高水平NLR(OR=0.678,95%CI:0.476-0.897;P=0.038)和血管侵犯(OR=1.489;95%CI:1.002-2.234;P=0.039)为降低总生存期的独立影响因素。结论:术前高水平的NLR是降低不能手术切除的肝癌患者总生存期的独立影响因素;术后患者的NLR升高与下降相比,NLR水平的升高对患者的预后更有利。OBJECTIVE： To evaluate the inference of neutrophibto-lymphocyte ratio （NLR） on preding survival in patients with unresectable hepatocellular carcinoma （HCC） before and after transarterial chemoembolization treatment. METHODS： From Feb 2006 to Feb 2009, clinical and laboratory datas of 154 consecutive patients underwent transarterial chemoembolization for unresectable HCC were analyzed retrospectively. Their clinical factors for survival were evaluated by univariate analysis. Cox multiple regression was used in predicting the survival. NLR≥2.5 was considered to be elevated. RESULTS： A total of 154 patients were identified. Among them,69 had an elevated NLR. The median survival of patients with NLR≥2.5 was 8 months compared with 12 months for patients with NLR〈2. 5;a significant difference was found in overall survival （P=0. 003） between the two groups. Age≥50 y, NLR≥2.5, decreased NLR after treatment,large tumor（≥5 cm）, vascular invasion, and elevated AFP level all were predictors of poor survival. Multivariate analysis showed that NLR≥ 2.5 （OR= 0. 678,95 % CI： 0. 476 - 0. 897 ; P = 0. 038） and vascular invasion （OR= 1. 489;95 %CI： 1. 002--2. 234;P= 0. 039）were independent factors for predicting worse survival. CONCLUSION： A high NLR independently predicts poor survival in patients with unresectable HCC underwent transarterial chemoembolization treatment, and an increased NLR indicates a better outcome than a decreased NLR for patients after transarterial chemoembolization.

关 键 词：肝肿瘤 癌 肝细胞 中性粒细胞与淋巴细胞比值 肝动脉化疗栓塞术 预后 

分 类 号：R735.7[医药卫生—肿瘤]