中性粒细胞/淋巴细胞比值在胆囊癌根治术预后评估中的应用  

Neutrophil-lymphocyte ratio as a prognostic factor for gallbladder carcinoma after radical resection

作　　者：高恒毅[1] 张航[1] 徐晓东[1] 邹文彬[1] 林凯临 邓永春[1] 刘清泉[1] 江建新[1,2] 王敏[1] 朱峰[1] 秦仁义[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院胆胰外科,湖北省武汉市430030 [2]湖北省肿瘤医院肝胆外科,湖北省武汉市430079

出　　处：《世界华人消化杂志》2015年第35期5705-5710,共6页World Chinese Journal of Digestology

基　　金：国家自然科学基金资助项目;Nos.81071775;81101621~~

摘　　要：目的:探讨中性粒细胞/淋巴细胞比值(neutrophil-lymphocyte ratio,NLR)是否可以作为胆囊癌患者接受根治术后的预后指标.方法:回顾性分析2007-01/2010-06华中科技大学同济医院胆胰外科接受胆囊癌根治术治疗的胆囊癌患者的资料.根据患者术前外周静脉血NLR值分为低NLR组(NLR<5.0)和高N L R组(N L R≥5.0).比较两组患者的人口学、临床资料及病理学的差异.用单因素回归方法分析影响患者长期生存的变量,并将有统计学意义的变量导入COX多因素回归模型得到影响胆囊癌预后的独立危险因素.结果:本研究纳入了90例患者(低NLR组74例,高N L R组16例).低N L R组和高N L R组胆囊癌患者5年生存率分别为70.9%和27.6%(P<0.05).单因素分析显示肿瘤分化程度、淋巴结转移情况、侵犯肝脏、T分期、TNM分期、NRL(P<0.05)为影响胆囊癌预后的因素.COX多因素分析表明NLR是影响胆囊癌预后的独立危险因素(P<0.05).结论:NLR可以作为胆囊癌根治术后的预后因素,术前NLR≥5提示胆囊癌患者预后不良.AIM： To explore whether neutrophil/lymphocyte ratio （NLR） can be used as a prognostic indicator of gallbladder carcinoma （GBC） after radical resection. METHODS： We retrospectively collected the data of GBC patients who underwent radical resection at Tongji Hospital from January 2007 to June 2010. According to the preoperative NLR value, the patients were divided into a low NLR group （NLR 〈 5.0） and a high NLR group （NLR ≥ 5.0）. We compared the demographic, clinical and pathological variables of the two groups. Univariate analysis was used to identify the factors affecting the prognosis of GBC, and the significant factors entered into a COX regression model to identify independent prognostic factors for GBC after radical surgery.RESULTS： A total of 90 patients were included in this study. The 5-year survival rates of the low NLR group and high NLR group were 70.9% and 27.6% （P 〈 0.05）, respectively. Univariate analysis showed that tumor differentiation, lymph node metastasis, liver invasion, T stage, TNM stage and NLR were factors affecting prognosis of GBC. COX regression analysis indicated that NLR was an independent predictive factor for prognosis of GBC after operation （P 〈 0.05）. CONCLUSION： NLR can serve as a prognostic indicator in GBC patients who underwent radical therapy. GBC patients with elevated NLR have a worse prognosis after operation.

关 键 词：胆囊癌 中性粒细胞/淋巴细胞比值 生存期 

分 类 号：R735.8[医药卫生—肿瘤]