入院时PNLR作为转移性结直肠癌患者预后标志物的研究  

Study of PNLR as a prognostic marker in patients with metastatic colorectal cancer on admission

作　　者：潘艳玲[1] 袁峰[1] PAN Yanling;YUAN Feng(Department of Tumor Radiotherapy,Haikou Hospital Affiliated to Xiangya Medical College of Central South University,Hainan,Haikou 570208,China)

机构地区：[1]中南大学湘雅医学院附属海口医院肿瘤放疗科,海口市570208

出　　处：《河北医药》2020年第5期706-709,713,共5页Hebei Medical Journal

摘　　要：目的探讨入院时血小板中性粒细胞与淋巴细胞比率(platelets-neutrophils to lymphocytes ratio,PNLR)与转移性结直肠癌患者临床病理特征的关系以及对患者预后的预测价值。方法回顾性选择2013年1月至2014年12月收治的转移性结直肠癌患者140例为研究对象。收集患者入院时血液标本,检测中性粒细胞、血小板和淋巴细胞数值,计算PNLR。绘制受试者工作特征曲线(receiver operating characteristic,ROC),确定PNLR最佳分界截点,并将患者分为PNLR<2000组(n=92)和PNLR≥2000组(n=48)。分析入院时PNLR与临床病理特征的关系。采用Kaplan-Meier法绘制不同PNLR组患者生存曲线,并应用Log-Rank检验进行比较。采用非条件Cox回归分析影响转移性结直肠癌患者预后的危险性因素。结果入院时PNLR与年龄、性别、辅助化疗、姑息化疗、寡转移、癌胚抗原(carcinoembryonic antigen,CEA)无关(均P>0.05),与临床表现、ECOG、新发转移、转移性切除术、乳酸脱氢酶(lactate dehydrogenase,LDH)、白蛋白、血小板、中性粒细胞、淋巴细胞有关(均P<0.05)。入组患者5年生存率为72.86%(102/140),PNLR<2000组患者5年生存率为81.52%(75/92)高于PNLR≥2000组的56.25%(27/48),差异有统计学意义(P<0.05)。非条件Cox回归分析发现,ECOG、CEA、白蛋白、PNLR是影响转移性结直肠癌患者生存的危险性因素(P<0.05)。结论入院时PNLR可作为预测转移性结直肠癌患者预后的重要指标,PNLR高者预后差。Objective To investigate the relationship between PNLR on admission and clinicopathological characteristics of patients with metastatic colorectal cancer,and to explore its predictive value for the prognosis of patients.Methods A total of 140 patients with metastatic colorectal cancer who were ad mitted and treated in our hospital from Jan 2013 to Dec 2014 were enrolled in the study,whose blood specimens were collected on admission.The levels of neutrophils,platelets and lymphocytes were measured and PNLR was calculated.Receiver operating characteristic(ROC)was drawn to determine the best cut-off point of PNLR.The patients were divided into PNLR<2,000 group(n=92)and PNLR<2,000 group(n=48).The correlation between PNLR and clinicopathological features on admission was analyzed.Survival curves of patients were drawn by Kaplan-Meier method and compared by Log-Rank test.Moreover the risk factors affecting prognosis of patients with metastatic colorectal cancer were aanalyzed by unconditional cox regression.Results The PNLR on admission was not related with patient’s age and sex,adjuvant chemotherapy,palliative chemotherapy,oligometastasis and CEA(P>0.05),however,which was related to clinical manifestations,ECOG,new metastasis,metastatic resection,LDH,albumin,platelets,neutrophils and lymphocytes(P<0.05).The 5-year survival rate was 72.86%(102/140),which in PNLR<2,000 group was 81.52%(75/92),which was significantly higher than that 56.25%(27/48)in PNLR<2,000 group(P<0.05).Unconditional cox regression analysis showed that ECOG,CEA,albumin and PNLR were the risk factors affecting the survival of patients with metastatic colorectal cancer(P<0.05).Conclusion PNLR on admission can be regarded as an important index in predicting the prognosis of patients with metastatic colorectal cancer,and the patients with higher PNLR have worse prognosis.

关 键 词：转移性结直肠癌 血小板中性粒细胞与淋巴细胞比率 预后 总生存率 

分 类 号：R735.35[医药卫生—肿瘤] R735.37[医药卫生—临床医学]