升高的血清中性粒细胞/淋巴细胞比值与肝内胆管癌较差的预后有关  

Elevated serum neutrophils-lymphocyte ratio predicts a worse prognoses in intrahepatic cholangiocarcinoma after liver resection

作　　者：刘建伟[1,2] 刘春颖[3] 夏勇[2] 闫振林[2] 李俊[2] 沈锋[1,2] 

机构地区：[1]福建医科大学第一临床医学院,福州350004 [2]第二军医大学东方肝胆外科医院肝外四科 [3]第二军医大学东方肝胆外科医院分子肿瘤研究室

出　　处：《肝胆外科杂志》2017年第1期21-27,共7页Journal of Hepatobiliary Surgery

基　　金：国家科技重大专项课题(2012ZXl0002-016)

摘　　要：目的探讨术前血清炎症指标与肝内胆管癌预后之间的关系。方法回顾性分析接受R0肝切除治疗的382例肝内胆管癌患者的临床病理资料,应用最小P值法确定炎症指标截断值,将每个炎症指标分为高低两组。应用KaplanMeier法描绘生存和复发曲线,Cox回归模型分析影响其预后的因素。结果 NLR(中性粒细胞数/淋巴细胞数)≥2.30是ICC患者术后总体生存和肿瘤复发的独立危险因素。NLR≥2.30的患者其血清癌胚抗原水平较高,肿瘤直径较大、多发肿瘤比例高、淋巴转移和血管侵犯比例大。结论 NLR≥2.30是肝内胆管癌患者预后的独立危险因素,NLR≥2.30的患者其术后总体生存率较差,肿瘤复发率更高。Objective To explore the association between preoperative serum inflammatory markers and prognosis in intrahe- patic cholangiocarcinoma （ICC） patients underwent liver resection. Methods Data of 382 consecutive ICC patients who underwent hepatectomy were retrospectively reviewed. The cut-off values of inflammation marker were calculated by using the minimum P value method. The curves of overall survival and tumor recurrence were depicted using the Kaplan-Meier method and compared using the log- rank test. Independent risk factors of OS and tumor recurrence were analyzed with the Cox hazard regression model. Results NLR （ nentrophil count divided by lymphocyte count）≥ 2. 30 was an independent risk factor of overall survival and tumor recurrence （ Haz- ard Ratio [HR] ： 1. 326, 95% Confidence Interval [CI] ： 1. 105-1. 593 ; 1. 270, 1. 071-1. 506）. Patients with a NLR≥2. 30 had higher CEA levels, larger tumor size, more tumor nodes, more lymph node metastasis and vascular invasion. Conclusions Inflamma- tory markers NLR ≥2. 30 is an independent risk factor of prognosis, which predicted a worse prognosis of ICC patients who underwent resection.

关 键 词：肝内胆管癌 炎症指标 肝切除 预后 

分 类 号：R735.7[医药卫生—肿瘤]