外周血中性粒/淋巴细胞比值对行TACE治疗的肝癌患者预后的影响  

Effects of blood neutrophil-to-lymphocyte ratio on predicting survival in patients with hepatocellular carcinoma undergoing transarterial chemoembolization

作　　者：廖媛[1] 潘淑茹[2] 曹宝华[1] 罗敏琪[1] LIAO Yuan;PAN Shuru;CAO Baohua;LUO Minqi(Department of Clinical Laboratory,the Third Affiliated Hospital of Sun Yat-sen University,Guangzhou 510630,China)

机构地区：[1]中山大学附属第三医院检验科,广州510630 [2]中山大学附属第三医院消化内科,广州510630

出　　处：《实用医学杂志》2018年第11期1787-1790,共4页The Journal of Practical Medicine

基　　金：广东省医学科研基金项目(编号:A2017336)

摘　　要：目的评价外周血中性粒/淋巴细胞比值(NLR)对行肝动脉栓塞化疗(TACE)的肝癌患者预后的影响及预测价值。方法回顾性分析51例接受TACE治疗的原发性肝癌患者的临床资料,分析其治疗前、治疗后3 d外周血NLR的水平及变化趋势与预后生存的关系。结果 51例患者治疗前外周血NLR中位值为2.95,其中治疗前NLR≥2.95的25例患者归入NLR高水平组,另外26例归入NLR低水平组。NLR高水平组患者的中位生存时间为6(1~25)个月,NLR低水平组患者的中位生存时间为12(3~30)个月,两组患者之间的中位生存时间差异有统计学意义(P=0.034)。经TACE治疗后3 d患者外周血NLR水平显著上升(P<0.001),其中NLR水平升高的患者(46例)中位生存时间为9个月,NLR水平下降的患者(5例)中位生存时间为5个月,两者间差异有统计学意义(P=0.022)。单因素分析显示治疗前甲胎蛋白水平升高(≥1 585 ng/mL)、血管侵犯、治疗前高水平NLR(≥2.95)和治疗后NLR水平下降均是影响总体生存时间的危险因素。多因素分析提示,血管侵犯和治疗后NLR水平下降是影响总体生存的独立预后因素。结论治疗后外周血NLR水平下降是影响肝癌患者行TACE治疗预后的独立危险因素,治疗前NLR水平高的患者其预后较差。Objective To evaluate the prognostic value of neutrophil-to-lymphocyte ratio（NLR）on patientswith hepatocellular carcinoma（HCC）receiving transarterial chemoembolization（TACE）. Methods Clinical andfollow-up data from 51 HCC patients who underwent TACE were collected retrospectively. The blood NLR levelsbefore and 3 days after treatment and its relationship with survival were analyzed. Results The HCC patients wereseparated into two groups according to the median level of pre-treatment NLR. Twenty-five patients with pre-treatment NLR ≥ 2.95 were recruited into high NLR group,while the other 26 patients were recruited into lowNLR group. The median survival time of patients in high NLR group was 6 months（range：1-15 months）,and thatwas 12 months（range：3 - 30 months）in low NLR group. There was a significant difference in the overall survivalbetween the two groups（P = 0.034）. The NLR level was significantly increased in HCC patients 3 days after TACE（P〈0.001）. The median survival time of HCC patients with increased NLR after TACE（46 cases）was 9 months,whereasthe survival time was 5 months in HCC patients with decreased NLR（5 cases）,indicating that the increasedNLR was associated with better outcomes（P = 0.022）. Elevated AFP level（≥ 1 585 ng/mL）,vascular invasion,high pre-treatment NLR level（≥ 2.95）and the post-treatment decreased NLR predicted poor survival in univariateanalysis. Multivariate analysis showed that vascular invasion and post-treatment decreased NLR were independentrisk factors for the prognosis of HCC patients undergoing TACE. Conclusions Post-treatment decreased NLRindependently predicts poor survival in HCC patients undergoing TACE and high pre-treatment NLR level indi-cates poor outcome for HCC patients undergoing TACE.

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 

分 类 号：R735.7[医药卫生—肿瘤]