氩氦冷冻消融术前外周血中性粒细胞与淋巴细胞比值对原发性肝癌患者预后的影响  

The neutrophil-to-lymphocyte ratio in peripheral blood in patients with hepatocellular carcinoma before argon-helium cryoablation:its influence on the prognosis

作　　者：杨红彩[1] 郭志[1] 司同国[1] 国永飞 杨雪玲[1] 邢文阁[1] 刘方[1] 刘长富[1] 张炜浩[1] 常旭[1] YANG Hong-cai GUO Zhi SI Tong- guo GUO Yong-fei YANG Xue-ling XING Wen-ge LIU Fang LIU Chang-fu ZHANG Wei-hao CHANG Xu.(Department of lnterventional Radiology, Tumor Hospital, Tianjin Medical University, National Clinical Research Center of Cancer, Key Laboratory of Cancer Prevention and Therapy of Tianjin, Tianjin 300060, Chin)

机构地区：[1]天津医科大学肿瘤医院介入科、国家肿瘤临床医学研究中心、天津市肿瘤防治重点实验室,300060

出　　处：《介入放射学杂志》2017年第1期30-34,共5页Journal of Interventional Radiology

基　　金：国家十二五科技支撑计划(2012BAI15B00);国家自然科学基金(81501568、81471761);天津市抗癌中单专项攻关计划(12ZXCZSY20300);天津市科技支撑计划重点项目(15ZCZDSY00890)

摘　　要：目的探讨原发性肝癌(HCC)患者氩氦冷冻消融术前外周血中性粒细胞与淋巴细胞比值(neutrophil to lymphocyte ratio,NLR)对患者预后的影响。方法回顾性分析72例HCC患者行经皮穿刺氩氦冷冻消融术的相关临床病理资料。根据术前NLR,分为低NLR组(NLR<3.5)和高NLR组(NLR≥3.5),统计分析两组患者术后的总生存期(overall survival,OS),并对其影响预后的危险因素进行单因素和多因素分析。结果所有患者经氩氦冷冻消融治疗后,中位生存期为22.4个月,其中高NLR组的中位生存期为13.2个月,低NLR组的中位生存期为24.2个月,两组中位生存期差异有统计学意义(P=0.003)。单因素分析显示:原发灶大小、肝功能Child-Pugh分级、白蛋白、总胆红素、胆碱酯酶、NLR是影响HCC患者氩氦冷冻消融术后生存期的相关因素(P<0.05)。多因素分析显示:原发灶大小和NLR是影响HCC患者氩氦冷冻消融术后生存的独立预后因素(P<0.05)。结论术前外周血中NLR可作为HCC患者行氩氦冷冻消融术的预后指标,肝内原发灶越大、NLR越高,患者预后越差。Objective To investigate the influence of neutrophil-to-lymphocyte ratio （NLR） in peripheral blood in patients with hepatoceUular carcinoma （HCC） before argon-helium cryoablation on the patient＇s prognosis. Methods The related clinical and pathological data of 72 HCC patients, who had received percutaneous argon- helium eryoablation, were retrospectively analyzed. Based on the preoperative NLR value, the patients were divided into low NLR group （NLR〈3.5） and high NLR group （NLR〉~3.5）. The postoperative overall survival time of the patients in the two groups were statistically analyzed, and the risk factors that might affect the prognosis were evaluated by using univariate and multivariate analysis. Results Argon-helium cryoablation was carried out in all patients. The median overall survival time was 22.4 months; the median overall survival time of the high NLR group and the low NLR group was 13.2 months and 24.2 months respectively, the difference in the overall survival time between the two groups was statistically significant （P=0.003）. Univariate analysis showed that the primary tumor size, liver function Child-Pugh classification, albumin, total bilirubin, cholinesterase and NLR value were the related factors that affected the postoperative overall survival time of HCC after argon-helium cryoablation （P〈0.05）. Multivariate analysis revealed that the primary tumor size and NLR value were the independent prognostic factors that affected the postoperative overall survival time of HCC after argon-helium cryoablation （P〈0.05）. Conehmion Preoperative NLR value in peripheral blood can be used as a prognostic indicator for patients with HCC undergoing argon- helium cryoablation; the larger the primary hepatic lesion is and/or the higher the NLR value is, the worse the prognosis of the patient will be.

关 键 词：原发性肝癌 中性粒细胞 淋巴细胞比值 氩氦冷冻消融术 预后 

分 类 号：R735.7[医药卫生—肿瘤]