外周血中性粒细胞与淋巴细胞比值在原发性肝癌肝切除术后肝功能不全中的预测价值  

Predictive value of peripheral neutrophil to lymphocyte ratio in patients with postoperative liver insufficiency after hepatectomy for primary liver cancer

作　　者：马春阳 陈冰燕 蔡鸿宇[1] 周元[1] 陈红健 张素青[1] 邵冰峰[1] 周益龙[1] MA Chunyang;CHEN Bingyan;CAI Hongyu;ZHOU Yuan;CHEN Hongjian;ZHANG Suqing;SHAO Bingfeng;ZHOU Yilong(Department of Hepatobiliary Surgery,Tumor Hospital Affiliated to Nantong University,Nantong 226361;Department of Clinical Laboratory,Tumor Hospital Affiliated to Nantong University,Nantong 226361)

机构地区：[1]南通大学附属肿瘤医院肝胆外科,南通226361 [2]南通大学附属肿瘤医院检验科,南通226361

出　　处：《南通大学学报（医学版）》2023年第1期42-45,共4页Journal of Nantong University(Medical sciences)

基　　金：南通市科技计划指导性项目(JCZ20132,JCZ20128);南通市卫计委重点病种的临床规范化诊疗项目。

摘　　要：目的:分析外周血中性粒细胞(neutrophil,NEU)计数与淋巴细胞(lymphocyte,LYM)计数比值(neutrophil/lymphocyte ratio,NLR)在预测原发性肝癌肝切除术后肝功能不全(postoperative liver insufficiency,PLI)中的应用价值。方法:按照纳入标准和排除标准,选择2018年1月—2020年12月在南通大学附属肿瘤医院肝胆外科住院治疗的204例原发性肝癌患者,将出现PLI的患者纳入观察组,未发生PLI者纳入对照组,分别收集两组患者的临床资料,比较两组患者术前NEU计数、NLR和吲哚菁绿清除试验15 min滞留率(indocyanine green clearance test 15-minute retention rate,ICG-R15),分析NLR在预测PLI中的应用价值。结果:两组患者术前NEU计数、NLR及ICG-R15比较差异均有统计学意义(均P<0.05)。单因素二元Logistic回归分析显示术前外周血NEU、NLR及ICG-R15均为原发性肝癌患者行肝切除术后发生PLI的影响因素。ROC曲线分析显示,NLR、ICG-R15及两者联合的AUC分别为0.701、0.603及0.622,其中NLR的AUC最大。结论:原发性肝癌患者术前外周血NEU计数、NLR及ICG-R15均为PLI发生的影响因素,其中NLR可有效预测原发性肝癌患者肝切除术后PLI的发生,与NLR联合能提高ICG-R15对PLI的预测价值。Objective:To analyze the predictive value of neutrophil(NEU)count and lymphocyte(LYM)count ratio(NLR)in peripheral blood for predicting postoperative liver insufficiency(PLI)after hepatectomy for primary liver cancer.Methods:According to the inclusion and exclusion criteria,204 patients with primary liver cancer performed with hepatectomy who were hospitalized in the Department of Hepatobiliary Surgery of Tumor Hospital Affiliated to Nantong University from January 2018 to December 2020 were selected.Patients with PLI were included in the observation group,and those without PLI were included in the control group.The clinical data of the two groups were collected,and preoperative NEU count,NLR value and indocyanine green clearance test 15-minute retention rate(ICG-R15)were compared between the two groups to analyze the application value of NLR in predicting PLI.Results:There were significant differences in preoperative NEU count,NLR and ICG-R15 between the two groups(all P<0.05).Univariate Logistic regression analysis showed that preoperative peripheral blood NEU,NLR and ICG-R15 were all influencing factors for the occurrence of PLI in patients with primary liver cancer after hepatectomy.ROC curve analysis showed that the AUC of NLR,ICG-R15 and their combination were 0.701,0.603 and 0.622,respectively,and the AUC of NLR was the largest.Conclusion:Preoperative peripheral NEU count,NLR and ICG-R15 are all influencing factors of PLI in patients with primary liver cancer.NLR can effectively predict the occurrence of PLI in patients with primary liver cancer after hepatectomy,and the combination of NLR and ICG-R15 can improve the predictive value of ICG-R15 for PLI.

关 键 词：原发性肝癌 肝切除术 术后肝功能不全 外周血 中性粒细胞与淋巴细胞比值 吲哚菁绿清除试验15 min滞留率 

分 类 号：R743.31[医药卫生—神经病学与精神病学]