中性粒细胞与淋巴细胞比值对壶腹癌预后的影响分析

Neutrophil-lymphocyte ratio as a prognostic factor for carcinoma of ampulla of Vatar

回顾性分析1998年1月至2012年12月间在中国医学科学院肿瘤医院腹部外科接受根治性手术，且临床资料完整和术后随访资料完整的147例壶腹癌患者的临床资料。低中性粒细胞/淋巴细胞比值（NLR）组（NLR＜5，121例）5年无病生存率为57.9％，高NLR组（NLR≥5，26例）为27.6％，两者差异有统计学意义（ P＝0.005）；单因素分析肿瘤分化（ P＝0.008）、淋巴结转移（ P＝0.008）、侵犯胰腺（P＝0.002）、肿瘤侵犯深度（P＝0.006）、肿瘤分期（P＝0.003）、术前NLR（P＝0.005）为壶腹癌的预后影响因素；多因素分析术前NLR是影响本组壶腹癌预后的独立危险因素（P＜0.05）。表明NLR作为壶腹癌预后评价指标具有重要的价值。

The clinical data of 147 patients with carcinoma of ampulla of Vatar at our hospital from January 1998 to December 2012 were retrospectively analyzed.The neutrophil-to-lymphocyte ratio （ NLR） was calculated from pre-operative complete blood count.They were divided into low NLR group （NLR＆lt;5,n=121） and high NLR group （NLR≥5,n=26）.The 5-year survival rates of two groups were compared and the prognostic risk factors examined by univariate analysis and Cox model.The 5-year free survival rates of low and high NLR groups were 57.9%and 27.6%respectively （ P=0.005 ）.Univariate analysis revealed that depth of invasion （P=0.006）,pancreatic invasion （P=0.002）,lymph nodal metastasis （P=0.008）, poor differentiation （ P =0.008 ） , tumor stage （ P =0.003 ） and per-operative NLR （ P =0.005 ） were significant prognostic factors.Multivariate analysis showed that per-operative NLR significantly increased the risk of recurrence （P＆lt;0.05）.Pre-operative NLR represents a significant independent prognostic indicator for patients with carcinoma of ampulla of Vatar.