术前外周血NLR和PLR对结肠癌术后肝转移的影响  

Effect of preoperative peripheral blood NLR and PLR on postoperative colon cancer liver metastasis

作　　者：何慧玲 鲁祖斌 冯嘉莉 梁声强 He Huiling;Lu Zubin;Feng Jiali;Liang Shengqiang(Clinical Laboratory,Southeast Hospital Affiliated to Xiamen University(the 909th Hospital),Zhangzhou 363000,China;Department of Gastroenterology,Southeast Hospital Affiliated to Xiamen University(the 909th Hospital),Zhangzhou 363000,China)

机构地区：[1]厦门大学附属东南医院(第九〇九医院)检验科,福建省漳州市363000 [2]厦门大学附属东南医院(第九〇九医院)消化内科,福建省漳州市363000

出　　处：《中华肝脏外科手术学电子杂志》2024年第5期682-687,共6页Chinese Journal of Hepatic Surgery(Electronic Edition)

摘　　要：目的探讨结肠癌患者术前外周血中性粒细胞与淋巴细胞比值(NLR)、血小板与淋巴细胞比值(PLR)对术后肝转移的影响。方法回顾性分析2017年1月至2018年12月在厦门大学附属东南医院诊治的188例结肠癌患者临床资料。患者均签署知情同意书,符合医学伦理学规定。其中男98例,女90例;年龄41~64岁,中位年龄52岁。根据术后随访1年内是否发生肝转移分为转移组(44例)和非转移组(144例)。以术前外周血NLR中位数2.4和PLR中位数216为临界值分为高NLR组、低NLR组和高PLR组、低PLR组。分析NLR、PLR与患者临床病理特征的关系,采用Logistic多因素回归分析结肠癌术后肝转移的影响因素,采用ROC分析NLR、PLR对结肠癌术后肝转移的预测效能。结果Logistic多因素分析显示,术前CEA≥5μg/L(OR=3.480,95%CI:1.157~10.467)、浸润浆膜(OR=3.332,95%CI:1.151~9.646)、脉管侵犯(OR=4.857,95%CI:1.650~14.293)、术后未化疗(OR=4.370,95%CI:1.429~13.362)、NLR>2.4(OR=6.800,95%CI:2.048~22.573)、PLR>212(OR=8.546,95%CI:2.490~29.326)是结肠癌术后肝转移的独立影响因素(P<0.05)。NLR对结肠癌术后肝转移预测的ROC曲线下面积(AUC)为0.867(95%CI:0.779~0.937),敏感度为0.818,特异度为0.834;PLR对结肠癌术后肝转移预测的AUC为0.919(95%CI:0.868~0.969),敏感度为0.818,特异度为0.917;NLR联合PLR对结肠癌术后肝转移预测的AUC为0.922(95%CI:0.873~0.970),敏感度为0.841,特异度为0.903。结论术前NLR和PLR升高与结肠癌不良病理特征有关,NLR和PLR升高是结肠癌术后肝转移的独立影响因素,联合NLR和PLR对结肠癌术后肝转移有较好的预测效能。Objective To evaluate the effect of neutrophil-lymphocyte ratio(NLR)and platelet-lymphocyte ratio(PLR)on postoperative liver metastasis in patients with colon cancer.Methods Clinical data of 188 patients with colon cancer admitted to Southeast Hospital Affiliated to Xiamen University from January 2017 to December 2018 were retrospectively analyzed.The informed consents of all patients were obtained and the local ethical committee approval was received.Among them,98 patients were male and 90 female,aged from 41 to 64 years,with a median age of 52 years.All patients were divided into the metastasis(n=44)and non-metastasis groups(n=144)according to whether liver metastasis occurred within postoperative 1 year.According to the median cut-off values of preoperative NLR(2.4)and PLR(216),all patients were divided into the high and low NLR groups,and high and low PLR groups,respectively.The relationship between NLR and PLR and clinicopathological characteristics was analyzed.The influencing factors of postoperative colon cancer liver metastasis were identified by Logistic multivariate regression analysis.The predictive efficiency of NLR and PLR for postoperative colon cancer liver metastasis was assessed by the receiver operating characteristic(ROC)curve.Results Logistic multivariate analysis showed that CEA≥5μg/L(OR=3.480,95%CI:1.157-10.467),serosa infiltration(OR=3.332,95%CI:1.151-9.646),vascular invasion(OR=4.857,95%CI:1.650-14.293),no postoperative chemotherapy(OR=4.370,95%CI:1.429-13.362),NLR>2.4(OR=6.800,95%CI:2.048-22.573),PLR>212(OR=8.546,95%CI:2.490-29.326)were the independent influencing factors of postoperative colon cancer liver metastasis(P<0.05).The area under the ROC curve(AUC)of NLR for predicting postoperative colon cancer liver metastasis was 0.867(95%CI:0.779-0.937),with a sensitivity of 0.818 and a specificity of 0.834.The AUC,sensitivity and specificity of PLR in predicting postoperative colon cancer liver metastasis were 0.919(95%CI:0.868-0.969),0.818 and 0.917,respectively.The AUC of NLR combine

关 键 词：中性粒细胞与淋巴细胞比值 血小板与淋巴细胞比值 结肠肿瘤 肿瘤转移 影响因素 预测 

分 类 号：R735.3[医药卫生—肿瘤]