中性粒细胞与淋巴细胞比值在原发性肝癌诊断及预后判断中的价值  

Value of neutrophil-to-lymphocyte ratio in the diagnosis and prognosis evaluation of primary hepatocellular carcinoma

作　　者：潘颖威 孟翔飞[1] 周林[1] 汪志强 张航宇 卢实春[1] 段伟东[1] Pan Yingwei;Meng Xiangfei;Zhou Lin;Wang Zhiqiang;Zhang Hangyu;Lu Shichun;Duan Weidong(Department of Hepatobiliary Surgery,the First Medical Center of Chinese PLA General Hospital,Beijing 100853,China)

机构地区：[1]解放军总医院第一医学中心肝胆外科,北京100853

出　　处：《肿瘤研究与临床》2020年第3期157-160,共4页Cancer Research and Clinic

摘　　要：目的探讨中性粒细胞与淋巴细胞比值(NLR)在原发性肝癌诊断及预后判断中的价值。方法回顾性分析2013年1月至2015年12月解放军总医院第一医学中心收治的病理诊断为原发性肝癌的100例患者临床资料,以肝癌诊断的常规标志物血清甲胎蛋白(AFP)为对照,采用四格表诊断试验的方法分析血清NLR诊断肝癌的灵敏度和特异度,并分析其与预后的相关性。结果100例肝癌患者中,高NLR(≥1.70)者比例为56%(56/100),高于AFP阳性者比例44%(44/100),但差异无统计学意义(χ^2=2.88,P=0.08)。AFP阳性患者中,低NLR与高NLR者的中位生存时间分别为59、48个月,差异有统计学意义(χ^2=3.91,P=0.048),且高NLR是影响肝癌患者预后的独立危险因素(HR=1.232,95%CI 1.055~1.438,P=0.008)。结论NLR联合AFP检测可提高肝癌的术前诊断率。高NLR是影响原发性肝癌患者预后的独立危险因素。Objective To investigate the value of neutrophil-to-lymphocyte ratio(NLR)in the diagnosis and prognosis evaluation of primary hepatocellular carcinoma.Methods The clinical data of 100 patients pathologically diagnosed as primary liver cancer who were admitted to the First Medical Center of Chinese PLA General Hospital from January 2013 to December 2015 were retrospectively analyzed.Serum alpha fetoprotein(AFP),a conventional marker for hepatocellular carcinoma diagnosis was used as the control.The fourfold table diagnostic test was applied to analyze the sensitivity and specificity of serum NLR in the diagnosis of hepatocellular carcinoma,and the correlation with the degree of tumor differentiation was also analyzed.Results The proportion of patients with high NLR(≥1.70)[56%(56/100)]was higher than the proportion of patients with positive AFP[44%(44/100)]in all 100 hepatocellular carcinoma patients,but the difference was not statistically significant(χ^2=2.88,P=0.08).Among AFP-positive patients,the median survival time of patients with low and high NLR was 59 and 48 months,respectively,and the difference was statistically significant(χ^2=3.91,P=0.048),and high NLR was an independent risk factor affecting the prognosis of hepatocellular carcinoma patients(HR=1.232,95%CI 1.055-1.438,P=0.008).Conclusions The detection of NLR combined with AFP can improve the diagnostic rate of hepatocellular carcinoma before surgery.High NLR is an independent risk factor affecting the prognosis of patients with primary hepatocellular carcinoma.

关 键 词：肝肿瘤 中性粒细胞与淋巴细胞比值 诊断 预后 

分 类 号：R735[医药卫生—肿瘤]