心脏代谢指数和中性粒细胞/淋巴细胞比值与结直肠癌患者预后关系研究  

Relationship between cardiometabolic index and neutrophil/lymphocyte ratio and prognosis of patients with colorectal cancer

作　　者：任雪康 朱少功 夏云展 REN Xuekang;ZHU Shaogong;XIA Yunzhan(Department of General Surgery,The Fifth Clinical Medical College of Henan University of Traditional Chinese Medicine(Zhengzhou People's Hospital),Henan Zhengzhou 450003,China)

机构地区：[1]河南中医药大学第五临床医学院(郑州人民医院)普通外科,河南郑州450003

出　　处：《现代肿瘤医学》2025年第4期641-647,共7页Journal of Modern Oncology

摘　　要：目的:探讨心脏代谢指数(cardiometabolic index, CMI)和术前中性粒细胞/淋巴细胞比值(neutrophil/lymphocyte ratio, NLR)与结直肠癌(colorectal cancer, CRC)患者预后关系。方法:选取我院普外科接受CRC根治术的107例CRC患者为研究对象。收集患者性别、年龄、肿瘤大小、位置、分化程度、CMI、术前NLR水平等资料。通过受试者工作特征(receiver operating characteristic, ROC)曲线选择CMI和NLR Cut-off值,将患者分别分为两组,比较不同CMI及NLR组患者临床病理特征及其与患者总生存期(overall survival, OS)的关系。联合CMI及NLR,采用Kaplan-Meier绘制不同CMI、NLR水平的患者OS生存曲线图,探索其与CRC患者预后关系。采用多因素Cox比例风险回归分析CRC患者术后预后影响因素。结果:共入组患者107例。高CMI组患者出现淋巴结转移(P=0.002)、远处转移(P=0.003)较多,低分化肿瘤(P=0.001),TNM分期为Ⅱ-Ⅳ期占比较高(P=0.002)。高NLR组患者出现淋巴结转移(P<0.001)、远处转移(P=0.001)较多,低分化肿瘤(P=0.042),TNM分期为Ⅱ-Ⅳ期占比较高(P<0.001)。术前低CMI组患者OS高于高CMI组患者(χ^(2)=26.32,P<0.001);术前低NLR组患者OS高于高NLR组患者(χ^(2)=27.61,P<0.001)。联合术前CMI及NLR水平,同时出现术前CMI>1.435和NLR>3.65患者OS较低,预后较差,同时出现术前CMI≤1.435和NLR≤3.65和患者OS较高,预后较好(P<0.001)。多因素Cox比例风险回归分析显示肿瘤大小、分化程度、CMI及术前NLR水平是影响CRC术后预后的独立影响因素(均P<0.05)。结论:CRC患者CMI及术前NLR水平与预后密切相关,动态监测两者水平有助于为患者预后提供参考。Objective:To investigate the relationship between cardiometabolic index(CMI)and preoperative neutrophil/lymphocyte ratio(NLR)and the prognosis of patients with colorectal cancer(CRC).Methods:Choose 107 cases of CRC patients as the research object in our hospital which performed radical resection of CRC.Collect patients'gender,age,tumor size,location,degree of differentiation,CMI,preoperative NLR level and other data.The Cut-off values of CMI and NLR were selected by ROC curve,the patients were divided into two groups and the clinicopathological characteristics of patients in different CMI and NLR groups and their relationship with overall survival(OS)were compared.By combining CMI and NLR levels,Kaplan-Meier method was used to draw the OS survival curve of patients with different CMI and NLR levels,and explore their relationship with the prognosis of CRC patients.Multivariate Cox proportional hazards regression was used to analyze the prognostic factors of patients with CRC.Results:A total of 107 patients with CRC were enrolled.Patients in the high CMI group had more lymph node metastasis(P=0.002),primary metastasis(P=0.003),poorly differentiated tumors(P=0.001),and higher proportion of TNM stageⅡ-Ⅳ(P=0.002).Patients in the high NLR group had more lymph node metastasis(P<0.001),primary metastasis(P=0.001),poorly differentiated tumors(P=0.042),and higher proportion of TNM stageⅡ-Ⅳ(P<0.001).OS in patients with low CMI group was higher than that of high CMI group of patients(χ^(2)=26.32,P<0.001).OS in patients with low NLR group was higher than that of high NLR group of patients(χ^(2)=27.61,P<0.001).By combining CMI and NLR levels,patients with both CMI>1.435 and NLR>3.65 had lower OS and poor prognosis.Patients with both CMI≤1.435 and NLR≤3.65 had higher OS and better prognosis(P<0.001).Tumor size,differentiation degree and the level of CMI and preoperative NLR are independent risk factors for postoperative outcomes in CRC patients(all P<0.05).Conclusion:Preoperative CMI and NLR levels are closely rel

关 键 词：结直肠癌 心脏代谢指数 中性粒细胞/淋巴细胞比值 预后 

分 类 号：R735.3[医药卫生—肿瘤]