PNI与NLR对结直肠癌同时性肝转移患者预后的预测价值  

Predictive Value of Prognostic Nutritional Index and Neutrophil to Lymphocyte Ratio in Colorectal Cancer Patients with Synchronous Liver Metastases.

作　　者：倪子龙 朱正秋 周双 冯晓慧 NI Zilong;ZHU Zhengqiu;ZHOU Shuang(Department of Oncology,Affiliated Hospital of Xuzhou Medical University,Jiangsu 221000,China)

机构地区：[1]徐州医科大学附属医院肿瘤科,221000

出　　处：《医学研究杂志》2023年第3期165-169,5,共6页Journal of Medical Research

摘　　要：目的探讨预后营养指数(prognostic nutrition index,PNI)、中性粒细胞与淋巴细胞比值(neutrophil to lymphocyte ratio,NLR)对结直肠癌同时性肝转移(colorectal cancer synchronous liver metastasis,CRSLM)患者预后的预测价值。方法回顾性分析2012年1月~2020年9月在徐州医科大学附属医院经病理确诊的102例CRSLM患者的临床资料,根据受试者操作特征(ROC)曲线确定PNI、NLR的最佳临界值,将患者分别分为高、低水平组。通过Kaplan-Meier法绘制生存曲线,比较不同组间的无进展生存期(progression free survival,PFS)和总生存时间(overall survival,OS),通过COX比例风险回归模型分析影响患者预后的因素。结果PNI、NLR最佳临界值为50.45、3.80,高PNI组比低PNI组PFS和OS更长(12个月vs 7个月,P<0.01;26个月vs 14个月,P<0.01),低NLR组比高NLR组PFS和OS更长(9个月vs 8个月,P=0.025;22个月vs 15个月,P=0.014)。多因素分析结果显示,低PNI、未行根治手术、高临床危险评分(clinical risk score,CRS)是PFS独立预后不良因素,低PNI、未行根治手术、年龄>60岁、高CRS是OS的独立预后不良因素。结论PNI可作为CRSLM患者有效的预后指标,PNI降低提示预后不良。Objective To explore the prognostic value of prognostic nutrition index(PNI)and neutrophil to lymphocyte ratio(NLR)in patients with colorectal cancer synchronous liver metastasis(CRSLM).Methods The clinical data of 102 patients with CRSLM who were pathologically diagnosed in Affiliated Hospital of Xuzhou Medical University from January 2012 to September 2020 were analyzed retrospectively.The optimal critical values of NLR and PNI were determined by receiver operating characteristic(ROC)curve,and the patients were divided into high level group and low level group respectively.Survival curves were plotted by Kaplan-Meier method to compare the progression-free survival(PFS)and overall survival(OS)among different groups.were compared by Kaplan-Meier method.The prognostic factors influencing the prognosis of patients were analyzed by COX proportional risk model.Results The optimal critical values of PNI and NLR were 50.45 and 3.80.High PNI group was longer in PFS and OS than low PNI group(12 months vs 7 months,P<0.01;For 26 months vs 14 months,P<0.01),low NLR group was longer in PFS and OS than high NLR group(9 months vs 8 months,P=0.025;22 months vs 15 months,P=0.014).Multivariate analysis showed that low PNI,no radical operation and high clinical risk score(CRS)were independent poor prognostic factors for PFS,while low PNI,no radical operation,age>60 years and high CRS were independent poor prognostic factors for OS.Conclusion PNI can be used as an effective prognostic index for patients with CRSLM,and the decrease of PNI indicates poor prognosis.

关 键 词：预后营养指数 中性粒细胞与淋巴细胞比值 结直肠肿瘤 肝转移 预后 

分 类 号：R73[医药卫生—肿瘤]