中性粒细胞与淋巴细胞比值变化对结肠癌预后的评估价值

Value of evaluating prognosis of colon cancer by neutrophil to lymphocyte ratio

目的探讨中性粒细胞与淋巴细胞比值(NLR)变化对结肠癌预后的评估价值。方法选择进展期结肠癌手术患者81例,测定患者血中性粒细胞、淋巴细胞值并计算NLR,术后随访了解复发及生存率情况。结果术前、术后化疗前最佳分界点分别为3.5、3.7。术前NLR≤3.5纳入术前低NLR组(n=63),>3.5纳入术前高NLR组(n=18)。化疗前NLR≤3.7纳入化疗前低NLR组(n=55),>3.7纳入化疗前高NLR组(n=26)。术前高NLR组、化疗前高NLR组浸润深度为T3-4、有远处转移、低分化的比例分别高于术前低NLR组、化疗前低NLR组(P<0.05)。术前高NLR组、化疗前高NLR组3年无复发生存率分别低于术前低NLR组、化疗前低NLR组(P<0.05)。术前高NLR组中NLR降低患者及术前低NLR组中NLR升高患者的1年、3年无复发生存率分别与化疗前低NLR组及化疗前高NLR组比较,差异无统计学意义(P>0.05)。结论监测结肠癌患者NLR值的变化,可准确把握患者机体对肿瘤的免疫状态,评估手术对患者免疫功能的影响,并根据其影响制定相应的治疗措施,以改善患者预后。

Objective To investigate the value of evaluating prognosis of colon cancer by neutrophil to lymphocyte ratio （NLR） changes.Methods Eighty-one operating patients with advanced colorectal cancer were selected , their se-rum neutrophils , lymphocytes were determined , and NLR was calculated .The postoperative recurrence and existence rate during follow-up period were observed .Results The preoperative , postoperation before chemotherapy optimum cut off points were 3.5, 3.7.Patients whose NLR ≤3.5 were included in preoperative low NLR group （n=63）;NLR 〉3 .5 were included in preoperative high NLR group （ n=18 ） .Before chemotherapy , NLR≤3 .7 were included in before chemotherapy low NLR group （n=55）;before chemotherapy, NLR 〉3.7 were included in before chemotherapy high NLR group （ n=26 ） .The ratio of patients whose infiltration depth was T 3-4 , distant metastasis , poor differentiation in preoperative high NLR group and before chemotherapy high NLR group were respectively higher than those in preopera -tive low NLR group and before chemotherapy low NLR group （ P〈0 .05 ） .Three years non recurrence survival rates in preoperative high NLR group and before chemotherapy high NLR group were respectively lower than that in preoperative low NLR group and before chemotherapy low NLR group （ P〈0 .05 ） .The one year , three years non recurrence survival rates of patients whose NLR decreased in preoperative high NLR group , or patients whose NLR elevated in preoperative low NLR group had no statistically significance from before chemotherapy low NLR group or before chemotherapy high NLR group （ P〉0 .05 ） .Conclusion Monitoring the NLR change of patients with colorectal cancer can accurately grasp immune state of patients ’ body to tumor , assess the impaction of operation on immune function , and make corre-sponding treatment measures according to effect in order to improve the prognosis of the patients .