中性粒细胞/淋巴细胞比值及其变化值对肝细胞癌介入术后急性肝功能恶化风险的预测价值  

Value of neutrophil/lymphocyte ratio and its variation value in predicting risk of acute liver function deteri⁃oration after interventional treatment of hepatocellular carcinoma

作　　者：吴玲红 周敏[2] 卢瑶[1] 朱光炜[3] WU Linghong;ZHOU Min;LU Yao;ZHU Guangwei(Department of Statistics,Liuzhou Workers′Hospital/The Fourth Affiliated Hospital of Guangxi Med-ical University,Liuzhou 545001,China)

机构地区：[1]柳州市工人医院/广西医科大学第四附属医院统计科,广西柳州545000 [2]柳州市工人医院/广西医科大学第四附属医院普通外科二病区,广西柳州545000 [3]柳州市工人医院/广西医科大学第四附属医院医务部,广西柳州545000

出　　处：《实用医学杂志》2023年第6期713-718,共6页The Journal of Practical Medicine

基　　金：广西壮族自治区卫生健康委员会自筹项目(编号:Z20210032)。

摘　　要：目的探讨中性粒细胞/淋巴细胞比值(NLR)及其动态变化(△NLR)对肝细胞癌患者经导管动脉化疗栓塞(TACE)术后发生急性肝功能恶化(ALFD)风险的预测作用。方法回顾性分析本院2021年符合入组标准的患者131例,绘制ROC,确定NLR和△NLR的最佳截点,单因素和多因素logistic回归分析可能影响患者ALFD风险的临床因素。结果NLR和△NLR预测患者术后ALFD风险的最佳截点分别是3.81和4.45;单因素分析显示:BMI(P=0.022)、门静脉癌栓(P=0.004)、介入次数(P=0.020)、肿瘤大小(P=0.002)、活化部分凝血酶原时间(P=0.036)、总胆红素(P=0.031)、碱性磷酸酶(P=0.010)、AST/ALT(P=0.029)、NLR(P=0.042)和ΔNLR(P=0.039)可能与患者ALFD风险有关;多因素结果显示:有门静脉癌栓(OR=3.221)、活化部分凝血酶原时间(OR=1.145)、NLR(≥3.81)(OR=1.044)、△NLR(≥4.45)(OR=3.159)可能是影响患者ALFD风险的独立危险因素(均P<0.05);按临界值将患者分为4组,C组(OR=3.231,95%CI:1.292~8.076,P=0.012)、D组(OR=5.400,95%CI:1.610~18.113,P=0.006)患者发生ALFD较A组危险。结论NLR≥3.81且△NLR≥4.45组合是预测ALFD风险的独立预测因子。Objective To investigate the predictive value of neutrophil/lymphocyte ratio and its dynamic change on the risk of acute liver function deterioration(ALFD)after transcatheter arterial chemoembolization(TACE)in patients with hepatocellular carcinoma(HCC).Methods Clinical data of 131 patients who met the inclusion criteria in our hospital in 2021 were retrospectively analyzed.The ROC curve was drawn to determine the best cut⁃off point of NLR and△NLR.Univariate and multivariate logistic regression analysis were used to analyze the clinical factors that may affect the risk of ALFD in patients.Results The optimal cut⁃off point of NLR and△NLR for predicting the risk of postoperative ALFD were 3.81 and 4.45,respectively.Univariate analysis showed that BMI(P=0.022),portal vein tumor thrombus(P=0.004),number of interventions(P=0.020),tumor size(P=0.002),activated partial thromboplastin time(P=0.036),total bilirubin(P=0.031),alkaline phosphatase(P=0.010),AST/ALT(P=0.029)),NLR(P=0.042)andΔNLR(P=0.039)may be associated with the risk of ALFD.Multivariate analysis showed that portal vein tumor thrombus(OR=3.221),activated partial prothrombin time(OR=1.145),NLR(≥3.81)(OR=1.044),and△NLR(≥4.45)(OR=3.159)were independent risk factors for ALFD(all P<0.05).Patients were divided into four groups according to the cut⁃off value.The risk of ALFD in group C(OR=3.231,95%CI:1.292~8.076,P=0.012)and D(OR=5.400,95%CI:1.610~18.113,P=0.006)was higher than that in group A.Conclusion The combination of NLR≥3.81 and△NLR≥4.45 is an independent predictor of ALFD risk.

关 键 词：中性粒细胞/淋巴细胞比值 肝细胞癌 经导管动脉化疗栓塞术 急性肝功能恶化 

分 类 号：R735.7[医药卫生—肿瘤]