NLR和PLR预测经TACE治疗的原发性肝癌患者预后的价值初步分析  

Application of neutrophil/lym phocyte ratio and platelet/lymphocyte ratio in forecasting prognosis of patients with primary liver cancer underwent TACE

作　　者：方旭东[1] 方晓明[1] 陈达伟 陈少明[3] 姚宁[1] 张人超[4] Fang Xudong;Fang Xiaoming;Chen Dawei(Department of General Surgery, 117TH Hospital, Hangzhou 310013, Zhejiang Province, China)

机构地区：[1]解放军第117医院普外科,杭州市310013 [2]杭州绿城医院消化内科 [3]解放军第117医院消化内科,杭州市310013 [4]浙江大学附属邵逸夫医院普外科

出　　处：《实用肝脏病杂志》2018年第3期431-434,共4页Journal of Practical Hepatology

基　　金：原南京军区医学科技创新课题(编号:14MS142)

摘　　要：目的探讨应用中性粒细胞/淋巴细胞比值(NLR)和血小板/淋巴细胞比值(PLR)预测经动脉导管化学栓塞(TACE)治疗的原发性肝癌(PLC)患者预后的价值。方法回顾性分析2012年8月～2014年8月我院肝胆外科收治的98例PLC患者,均接受TACE治疗。采用多因素回归分析影响3 a生存率的因素,并绘制受试者工作特征曲线(ROC)判断NLR和PLR的预测价值。结果 98例经TACE治疗的PLC患者1 a、2 a和3 a生存率分别为53.1%、42.9%和39.8%;NLR≤1.82组1 a、2 a和3 a生存率分别为73.9%、56.5%和52.2%,而NLR>1.82组则分别为46.7%、38.7%和36.0%(P<0.05);PLR≤95.65组患者1 a、2 a和3 a生存率分别为70.0%、60.0%和53.3%,而PLR>95.65组则分别为45.6%、35.3%和33.8%(P<0.05);多因素分析结果显示,肿瘤个数≥2个、肿瘤直径>50mm和NLR>1.82预示PLC患者在TACE术后预后较差,均为影响患者术后生存的独立危险因素。结论在PLC患者行TACE术前应评估NLR水平,其水平高者,可能预后差。该方法简便易行,但需要扩大验证。Objective To investigate the application of neutrophil/lymphocyte ratio （NLR） and platelet/lymphocyte ratio（PLR）in forecasting prognosis of patients with primary liver cancer（PLC）underwent transcatheterarterial chemoembolization（TACE） . Methods A retrospective analysis of 98 patients with PLC was made,andthe patients were recruited in our hospital between August 2012 and August 2014. All of them received TACE,and followed-up for three years. The factors influencing 3-year survival rate was estimated by multivariate Logisticanalysis,and the receiver operating characteristic curve（ROC）was calculated to determine the efficacy of NLRand PLR in forecasting the patients’prognosis. Results The1, 2 and 3 year survival rates in the 98 patientswith PLC after TACE treatment were 53.1%, 42.9% and 39.8%; the1, 2 and3 year survival rates in 23 patientswith NLR〉1.82 were 73.9%, 56.5% and 52.2%, while they were 46.7%, 38.7% and 36.0%, respectively,（P〈0.05）in 75 patients with NLR〉1.82; the1, 2 and 3 year survival rates in 30 patients with PLR臆95.65 were 70.0%,60.0% and 53.3%, while they were 45.6%, 35.3% and 33.8%, respectively,（P〈0.05）in 68 patients with PLR〉95.65; multivariate Logistic analysis showed that tumor number≥2, tumor diameter 〉50 mm and NLR〉1.82 werethe independent factors that would influence the patients’prognosis. Conclusion The NLR should be assessedbefore TACE in patients with PLC, which is a easy marker to obtain and might be useful in clinical practice.

关 键 词：原发性肝癌 肝动脉栓塞化疗 中性粒细胞/淋巴细胞比值 血小板/淋巴细胞比值 预后 

分 类 号：R735.7[医药卫生—肿瘤]