结肠癌患者术前外周血中性粒细胞/淋巴细胞比值与预后的关系

Relation between preoperative peripheral blood neutrophil-to-lymphocyte ratio and prognosis in patients with colorectal cancer

目的探讨术前外周血中性粒细胞/淋巴细胞（NLR）在评估结肠癌患者预后方面的临床意义。方法回顾性分析该院2008年1月至2010年12月收治并接受根治性手术切除的95例结肠癌患者的临床资料,采用ROC曲线确定NLR最佳截点,将患者分为高NLR组和低NLR组,比较两组5年生存率,进行预后危险因素分析。结果以3作为截点将95例患者分为高NLR组（57例）与低NLR组（38例）。低NLR组患者的5年总体生存率（43.9%）显著高于高NLR组（10.5%）（P〈0.01）。单因素分析结果显示,临床分期、淋巴结转移、远处转移、癌胚抗原和NLR是影响结肠癌患者术后生存时间的危险因素。多因素分析结果显示,NLR是影响结肠癌患者术后生存时间的独立危险因素（HR=3.387,95%CI：1.856~6.181,P〈0.01）。结论术前外周血NLR是评估结肠癌患者预后的独立危险因素。

Objective To evaluate the clinical significance of preoperative peripheral blood neutrophil-to-lymphocyte ratio（NLR）in evaluating the prognosis in the patients with colorectal cancer.Methods The clinical data of95 patients with colorectal cancer in our hospital from Jan.2008 to Dec.2010 were retrospectively analyzed.The receiver operating characteristic（ROC）curve was adopted to determine the best cut off point,and the patients were divided into the high NLR group and the low NLR group according to the cut off point.The overall 5-year survival rates were compared between the two groups.The prognostic risk factors were also analyzed.Results With 3as the cut off point,95 cases were divided into the high NLR group（57cases）and low NLR group（38cases）.The overall 5-year survival rate of the low NLR group was 43.9%,which was significantly higher than 10.5%in the high NLR group（P〈0.01）.The univariate analysis results showed that the clinical stage,lymph node metastasis,distant metastasis,CEA and NLR were the risk factors affecting the postoperative survival time in the patients with colorectal cancer.The multivariate analysis results showed that NLR was an independent risk factor affecting the postoperative survival time in the patients with colorectal cancer（HR=3.387,95%CI：1.856-6.181,P〈0.01）.Conclusion Preoperative peripheral blood NLR is an independent prognostic factor for evaluating the prognosis in the patients with colorectal cancer.