淋巴细胞单核细胞比值与结直肠癌临床特征及预后的相关性分析  

Analysis of correlation between ratio of lymphocyte to monocyte and clinical characteristics and prognosis of colorectal cancer

作　　者：周超[1] 闫军浩[1] 唐坚[1] 崔喆[1] 王争[1] ZHOU Chao;YAN Junhao;TANG Jian;CUI zhe;WANG Zheng

机构地区：[1]上海交通大学医学院附属仁济医院胃肠外科,上海200001

出　　处：《肿瘤》2017年第12期1297-1303,共7页Tumor

基　　金：上海交通大学医学院附属仁济医院临床科研创新培育基金计划(编号:PYZY16-007)~~

摘　　要：目的:探讨术前淋巴细胞/单核细胞比值(ratio of lymphocyte to monocyte,LMR)与结直肠癌临床特征及预后的相关性。方法:回顾性分析2010年1月—2012年5月在上海交通大学医学院附属仁济医院胃肠外科行手术治疗且随访资料完整的218例结直肠患者的临床病理资料。根据受试者工作特征(receiver operating characteristic,ROC)曲线结果确定LMR预测术后5年总生存率的最佳截断值(cut-ovalue),将患者分为低LMR组和高LMR组。比较2组临床病理特征的差异。应用Kaplan-Meier法计算生存率,并采用log-rank检验对组间生存率进行比较,COX比例风险模型分析结直肠患者预后的影响因素。结果:术前LMR预测术后5年总生存率的最佳截断值为4.7,由此将入组患者分为2组,即高LMR组(LMR>4.7)和低LMR组(LMR≤4.7)。2组患者的T分期和临床分期差异有统计学意义(P值均<0.05)。术前高LMR组和低LMR组结直肠癌患者的术后5年总生存率分别为72.2%和48.6%(P=0.008)。预后的单因素分析结果显示,N分期、临床分期、术前癌胚抗原水平和术前LMR与结直肠癌患者术后5年总生存率相关(P值均<0.05)。多因素分析结果显示,N分期、临床分期和术前LMR均是结直肠癌患者术后5年总生存率的独立预后因素(P值均<0.05)。结论:术前LMR≤4.7提示结直肠癌患者预后较差。术前LMR可作为结直肠癌患者的独立预后因素。Objective： To investigate the correlation between the ratio of lymphocyte to monocyte （LMR） and clinical characteristics and prognosis of colorectal cancer. Methods： The clinical and pathological data of 21 8 cases of colorectal cancer in Department of Gastrointestinal Surgery, Renji Hospital,Shanghai Jiao Tong University School of Medicine from January 20t0 to May 2012 were analyzed retrospectively. According to the result of receiver operating characteristic curve analysis, the optimal cut-off value for post-operative 5-year overall survival rate was predicted and the patients were divided into pre-operative low LMR and high LMR groups. The differences in clinical characteristics between the two groups were analyzed; the survival rate was calculated using the Kaplan-Meier method and the difference between the two groups was compared by log-rank test. The COX proportional hazards model was used to analyze the prognostic factors for colorectal cancer. Results： The optimal cut-off value was 4.7 and the patients were accordingly divided into two groups, namely high LMR group （LMR 〉 4.7） and low LMR group （LMR - 4.7）. The differences in T stage and clinical stage were statistically significant between two groups （both P 〈 0.05）. The post-operative 5-year overall survival rates of patients with high LMR and low LMR were 72.2% and 48.6%, respectively （P = 0.008）. Univariate prognostic analysis showed that N stage, clinical stage, preoperative carcinoembryonic antigen （CEA） level and pre-operative LMR were associated with post-operative 5-year overall survival of colorectal cancer patients （all P 〈 0.05）. Multivariate analysis confirmed that N stage, clinical stage and pre-operative LMR were independent prognostic factors for colorectal cancer （all P 〈 0.05）. Conclusion： Pre-operative LMR ≤ 4.7 means a poor prognosis for colorectal cancer patients and pre- operative LMR can be used as an independent prognostic factor for patients with colorectal cancer.

关 键 词：结直肠肿瘤 淋巴细胞单核细胞比值 术前评估 预后 

分 类 号：R735.3[医药卫生—肿瘤]