术后中性粒细胞/淋巴细胞比值对局部进展期胰腺癌纳米刀消融术后患者预后的预测价值  

Prognostic Value of Postoperative Neutrophil to Lymphocyte Ratio in Patients with Locally Advanced Pancreatic Cancer After Nanoknife Ablation

作　　者：魏广坤 陈艳军[1] 程冰冰[1] 仝昊 陈升阳[1] 胡水全 WEI Guangkun;CHEN Yanjun;CHENG Bingbing;TONG Hao;CHEN Shengyang;HU Shuiquan(Department of Hepatobiliary and Pancreatic Surgery,the Fifth Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,China)

机构地区：[1]郑州大学第五附属医院肝胆胰外科,河南郑州450000

出　　处：《河南医学研究》2025年第2期220-225,共6页Henan Medical Research

基　　金：河南省医学科技攻关计划联合共建项目(2018020258)。

摘　　要：目的探讨术后中性粒细胞/淋巴细胞比值(NLR)对局部进展期胰腺癌纳米刀消融术后患者的预后意义。方法回顾性分析2015年7月至2020年5月于郑州大学第五附属医院经纳米刀治疗,符合纳入标准的45例局部进展期胰腺癌患者的临床资料。根据患者术后外周静脉血NLR值,以NLR的中位数为临界值,将病例分为低NLR组(NLR≤4.8,22例)和高NLR组(NLR>4.8,23例),应用χ^(2)检验比较两组间的差异性。采用Cox比例风险模型多因素分析,探究NLR是否为影响胰腺癌患者纳米刀术后预后的独立危险因素。结果低NLR组患者的中位生存时间为294d,而高NLR组患者的中位生存时间为126d(P<0.001)。单因素分析结果显示:肿瘤直径(P<0.001)、糖类抗原19-9(CA19-9)(P<0.001)、肿瘤部位(P=0.030)、分化程度(P=0.006)、术后30dNLR(P<0.001)、TNM分期(P=0.016)与局部进展期胰腺癌纳米刀术后生存有关。多因素分析结果显示:肿瘤直径、术后NLR、肿瘤标志物CA19-9是局部进展期胰腺癌预后的独立影响因素。结论术后高NLR对于局部进展期胰腺癌纳米刀术后患者的生存期具有一定的预测价值,NLR在临床中易于检验,可以提供重要的预后信息。Objective To investigate the prognostic significance of neutrophil to lymphocyte ratio(NLR)in patients with locally advanced pancreatic cancer after nanolithotomy.Methods From July 2015 to May 2020,the clinical data of 45 patients with locally advanced pancreatic cancer who met the inclusion criteria and were treated with nanoknives in the Fifth Affiliated Hospital of Zhengzhou University were retrospectively analyzed.According to the NLR value of postoperative peripheral venous blood,patients were divided into low NLR group(NLR≤4.8,22 cases)and high NLR group(NLR>4.8,23 cases)with the median NLR as the critical value.χ^(2)test was used to compare the difference between the two groups.Multivariate analysis of Cox proportional risk model was used to investigate whether NLR was an independent risk factor for the prognosis of patients with pancreatic cancer afer nanoknife surgery.Results The median survival time was 294 days in the low NLR group and 126 days in the high NLR group(P<0.001).The results of single factor analysis showed that tumor diameter(P<0.001),carbohydrate antigen 19-9(CA19-9)(P<0.001),tumor site(P=0.030),degree of diferentiation(P=0.006),30 days after surgery NLR(P<0.001)and TNM stage(P=0.016)were associated with survival after nanolithotomy for locally advanced pancreatic cancer.The results of multivariate analysis showed that tumor diameter,postoperative NLR and tumor marker CA19-9 were independent factors influencing pancreatic prognosis of locally advanced pancreatic cancer.Conclusion Postoperative high NLR has a certain predictive value for the survival of patients with locally advanced pancreatic cancer after nano-knife surgery.NLR is easy to test in clinical practice and can provide important prognostic information.

关 键 词：胰腺癌 局部进展期 纳米刀消融 中性粒细胞/淋巴细胞比值 

分 类 号：R735.9[医药卫生—肿瘤]