炎症标志物对结直肠癌患者预后影响的临床研究  

Clinical Research on the Influence of Inflammatory Biomarkers on the Prognosis of Patients with Colorectal Cancer

作　　者：杨战锋[1] 郭晓磊[1] 郭魁元[1] 吴万庆[1] 闫军浩 YANG Zhanfeng;GUO Xiaolei;GUO Kuiyuan(Department of General Surgery,The Fifth Affiliated Hospital of Zhengzhou University,Henan 450052,China)

机构地区：[1]郑州大学第五附属医院普外科,450052

出　　处：《医学研究杂志》2023年第1期143-147,142,共6页Journal of Medical Research

摘　　要：目的探讨术前外周血血小板淋巴细胞比值(platelet to lymphocyte ratio,PLR)、单核细胞淋巴细胞比值(monocyte to lymphocyte ratio,MLR)、中性粒细胞淋巴细胞比值(neutrophil to lymphocyte ratio,NLR)、系统免疫炎症指数(systemic immune inflammation index,SII)对结直肠癌根治术患者预后的影响。方法回顾性分析2012年10月~2017年10月于郑州大学第五附属医院行根治性结直肠癌切除术的357例患者的临床及随访资料,采用时间依赖性受试者操作特征(receiver operator characteristic,ROC)曲线确定炎症标志物的最佳截断值,并将患者分为高值组和低值组,研究炎性标志物高值组与低值组与患者临床病理特征及生存情况之间的关系,采用单因素和多因素COX回归分析评价影响患者预后的因素。结果PLR、MLR、NLR、SII值高与患者白蛋白值低均明显相关(P<0.05)。PLR、MLR、NLR、SII高值组患者总体生存率均明显低于低值组患者(P<0.05)。单因素COX回归分析结果显示,年龄、TNM分期、分化程度、癌胚抗原(carcinoembryonic antigen,CEA)水平、PLR、MLR、NLR、SII与患者预后显著相关(P<0.05)。多因素COX回归分析结果显示,年龄、TNM分期、CEA水平、MLR、SII是影响结直肠癌患者生存的独立危险因素(P<0.05)。结论术前MLR及SII可作为评估结直肠癌患者预后的重要指标,高MLR、高SII提示预后较差。Objective To investigate the influence of preoperative peripheral blood platelet to lymphocyte ratio(PLR),monocyte to lymphocyte ratio(MLR),neutrophil to lymphocyte ratio(NLR),systemic immune inflammation index(SII)on the prognosis of patients with colorectal cancer after radical operation.Methods The clinical and follow-up data of 357 patients undergoing radical resection of colorectal cancer in the Fifth Affiliated Hospital of Zhengzhou University from October 2012 to October 2017 were analyzed retrospectively.The optimal cutoff values of inflammatory biomarkers for survival prediction of postoperative patients were determined by time-dependent receiver operator characteristic(ROC)curve,and patients were accordingly allocated into high value group and low value group.The relationship between high value group and low value group of inflammatory biomarkers and the clinicopathological features and overall survival of patients was researched.Univariate and multivariate COX regression model were used to analyze the factors affecting patients′survival.Results The high values of PLR,MLR,NLR and SII were significantly correlated with low albumin values in patients(P<0.05).The overall survival rate of high value group of PLR,MLR,NLR and SII were significantly lower than that of low value group(P<0.05).Univariate COX analysis demonstrated that age,TNM stage,degree of differentiation,carcinoembryonic antigen(CEA)level,PLR,MLR,NLR and SII were significantly associated with prognosis of patients(P<0.05).Multivariate COX analysis revealed that age,TNM stage,CEA level,MLR and SII were independent risk factors for survival of the colorectal cancer patients(P<0.05).Conclusion Preoperative MLR and SII could be used as important prognostic indicators for colorectal cancer patients,and patients with high MLR or high SII indicate poor prognosis.

关 键 词：结直肠癌 炎症 生存 预后 

分 类 号：R73[医药卫生—肿瘤]