术前中性粒细胞-淋巴细胞比及CA19-9对胆囊癌根治术预后判断价值  

Preoperative neutrophil-lymphocyte ratio and CA19-9 in predicting prognosis of patients undergoing radical cholecystectomy

作　　者：鲍建亨[1] 尚海涛[1] 郝成飞[1] 韩树旺 宋仕军 张德林 李忠廉[1] BAO Jian-heng;SHANG Hai-tao;HAO Cheng-fei(Department of Hepatobiliary and Pancreatic Surgery,Nankai Hospital,Tianjin 300100,China)

机构地区：[1]天津市南开医院肝胆胰外科,天津300100

出　　处：《肝胆外科杂志》2019年第5期374-379,共6页Journal of Hepatobiliary Surgery

摘　　要：目的分析胆囊癌患者术前中性粒细胞-淋巴细胞比(NLR)和血清CA19-9对患者的预后的判断价值.方法收集2012年1月至2019年5月间在天津市南开医院接受胆囊癌根治术的患者临床资料.使用Cox回归比例风险模型和Kaplan-Meier方法分析患者的预后.并结合NLR和CA19-9将患者分为联合低水平组、单一升高组、联合高水平组.结果最终纳入90例患者,COX风险比例回归分析NLR(HR=3.840,P=0.000),CA19-9(HR=2.230,P=0.004),TNM分期(HR=3.864,P=0.000),淋巴结转移(HR=1.679,P=0.048),边缘状态(HR=1.873,P=0.030)是胆囊癌患者的独立预后影响因素.低NLR和CA19-9组的中位生存时间优于高NLR和CA19-9组(P<0.05).术前NLR和血清CA19-9与胆囊癌患者的预后相关.结论术前高NLR和高CA19-9是胆囊癌患者根治性术后预后不良的预测因素.Objective To analyze the prognostic value of preoperative neutrophil-lymphocyte ratio(NLR)and serum CA19-9 in patients with gallbladder cancer.Methods Clinical data of patients undergoing radical cholecystectomy in Nankai Hospital of Tianjin City from January 2012 to May 2019 were collected.Cox regression proportional hazard model and Kaplan-Meier method were used to analyze the prognosis of patients.Combined with NLR and CA19-9,the patients were divided into combined low-level group,singlelevel group and combined high-level group.Results Ninety patients were eventually included.COX risk ratio regression analysis showed that NLR(HR=3.840,P=0.000),CA19-9(HR=2.230,P=0.004),TNM stage(HR=3.864,P=0.000),lymph node metastasis(HR=1.679,P=0.048),marginal state(HR=1.873,P=0.030)were independent prognostic factors for gallbladder cancer patients.The median survival time of low NLR and CA19-9 group was better than that of high NLR and CA19-9 group(P<0.05).Preoperative NLR and serum CA19-9 were associated with the prognosis of gallbladder cancer patients.Conclusion Preoperative high NLR and CA19-9 are predictors of poor prognosis in patients with gallbladder cancer after radical surgery.

关 键 词：胆囊癌 肿瘤标志物 中性粒细胞-淋巴细胞比 预后 

分 类 号：R735.8[医药卫生—肿瘤]