术前血浆纤维蛋白原联合炎症相关标志物评分与非转移性结直肠癌患者病理特征及预后的相关性分析  

Correlation analysis of preoperative plasma fibrinogen combined with scores of inflammation-related markers and pathological characteristics as well as prognosis in patients with non-metastatic colorectal cancer

作　　者：彭正伟 李玲 聂瑚玮[1,2] 陈瑷玲 艾阳 张杰 杨文生 陈光宇 张林 PENG Zheng-wei;LI Ling;NIE Hu-wei;CHEN Ai-ling;AI Yang;ZHANG Jie;YANG Wen-sheng;CHEN Guang-yu;ZHANG Lin(School of Clinical Medicine,Southwest Medical University,Luzhou 646000,China;Department of Gastrointestinal Surgery,General Hospital of Western Theater Command of the Chinese People′s Liberation Army,Chengdu 610083,China;School of Clinical Medicine,Southwest Jiaotong University,Chengdu 610031,China)

机构地区：[1]西南医科大学临床医学院,四川泸州646000 [2]中国人民解放军西部战区总医院全军普外中心胃肠病区,四川成都610083 [3]西南交通大学医学院,四川成都610031

出　　处：《实用医院临床杂志》2023年第4期68-72,共5页Practical Journal of Clinical Medicine

基　　金：四川省科技厅重点研发项目(编号:2022YFS0440);四川省中医药管理局重点项目(编号:2021ZD014)。

摘　　要：目的探讨术前血浆纤维蛋白原(Fbg)联合炎症相关标志物与结直肠癌患者病理特征及预后的相关性。方法回顾性分析西部战区总医院2017年1月至2019年7月确诊为结直肠癌并行根治性手术的615例患者,收集术前常规血液学检测结果,计算中性粒细胞/淋巴细胞(NLR)、血小板/淋巴细胞(PLR)及单核细胞/淋巴细胞(MLR)。根据ROC曲线计算最佳临界值,将Fbg分别与NLR、PLR及MLR联合评分(F-NLR、F-PLR、F-MLR),分析不同评分与结直肠癌患者术后病理特征及预后的相关性。结果F-NLR评分与性别、肿瘤位置、T分期、是否神经侵犯之间差异有统计学意义(P<0.05);F-PLR评分与肿瘤位置、T分期之间差异有统计学意义(P<0.05);F-MLR评分与性别、年龄、肿瘤位置、T分期及是否神经侵犯差异有统计学意义(P<0.05)。多因素Cox回归分析显示,F-MLR评分是影响结直肠癌患者术后无病生存期(DFS)(P=0.002)及总生存期(OS)(P=0.005)的独立危险因素。结论Fbg与炎症相关标志物联合的F-NLR、F-PLR、F-MLR评分是一个可靠的预测结直肠癌患者预后的指标,且F-MLR评分更有助于判断结直肠癌患者的预后。Objective To investigate the correlation between the preoperative plasma fibrinogen(Fbg)combined with inflammation-related markers and the pathological features and prognosis of patients with colorectal cancer(CRC).Methods A retro-spective analysis of 615 patients who were diagnosed as colorectal cancer and underwent radical resection from January 2017 to July 2019 in the General Hospital of Western Theater Command of the Chinese People′s Liberation Army was performed.The routine hema-tological examination results were collected before operation.The ratio of neutrophils to lymphocytes(NLR),ratio of platelets to lym-phocytes(PLR)and ratio of monocytes to lymphocytes(MLR)were calculated.According to the optimal cutoff value of ROC curve,scores of F-MLR,F-PLR and F-MLR were constructed by combining Fbg with NLR,PLR and MLR,respectively.The correlations between different scores and postoperative pathological features as well as prognosis of the CRC patients were analyzed.Results There were statistically significant differences between F-NLR score and gender,tumor location,T stage,and nerve invasion(P<0.05).There were statistically significant differences between F-PLR score and tumor location,and T stage(P<0.05).There were statistically significant differences between F-MLR score and gender,age,tumor location,T stage and nerve invasion(P<0.05).Multivariate Cox regression analysis showed that F-MLR score was an independent risk factor for disease-free survival(DFS)(P=0002)and overall survival(OS)(P=0005)in these CRC patients.Conclusions The F-NLR,F-PLR and F-MLR scores constructed by Fbg combined with inflammation-related markers is a reliable predictor to predict the prognosis of CRC patients.The F-MLR score is more helpful to judge the prognosis of CRC patients.

关 键 词：结直肠癌 纤维蛋白原 中性粒细胞与淋巴细胞比值 血小板与淋巴细胞比值 单核细胞与淋巴细胞比值 炎性标志物 预后 

分 类 号：R735[医药卫生—肿瘤]