NLR、LMR水平与转移性结直肠癌维持治疗疗效及预后的相关性

A correlation study of NLR,LMR level in metastatic colorectal cancer patients and therapeutic efficacy of maintenance treatment as well as its prognostic value

目的:分析转移性结直肠癌维持治疗疗效及预后的相关因素,探讨炎症相关标记物与维持治疗疗效及预后的相关性。方法:筛选131例经标准化疗后缓解或稳定的转移性结直肠癌患者,分析其临床特征,筛选预后相关因子,探讨基线NLR、LMR水平对维持治疗疗效及预后的预测作用。结果:生存分析显示肿瘤分化程度高、基线高NLR、高LMR、低CA19-9水平患者进行维持治疗预后较好;基线高NLR水平维持治疗患者疾病控制率和中位无进展生存期均优于低NLR水平组,基线高LMR水平维持治疗患者的中位无进展生存期优于基线低LMR水平组。结论:肿瘤分化程度、基线NLR、LMR、CA19-9水平可作为转移性结直肠癌维持治疗患者的独立预后因子,基线NLR水平可作为维持治疗的疗效预测因子,基线高NLR水平患者更能从维持治疗中获益。

Objective：To analyze the relevant predictor of therapeutic efficacy and prognosis in metastatic colorec-tal cancer （mCRC） patients who received maintenance treatment after induction chemotherapy, and investigate the clinical value of inflammatory biomarkers to judge the efficacy and prognosis of maintenance treatment in mCRC pa-tients. Methods ： Screen 131 mCRC patients who achieved the state of complete response （ CR） , partial response （PR） or stable disease （ SD） after first - line or second - line standard chemotherapy. We analyzed the clinical char-acteristics of these mCRC patients, screened the prognostic factors, and investigated the predictive effect of baseline neutrophil - to - lymphocyte ratio （ NLR） , lymphocyte - to - monocyte （ LMR） level on therapeutic efficacy and prog-nosis for patients who received maintenance treatment after induction chemotherapy. Results ： Survival analyses indica-ted that high histological differentiated degree,high baseline NLR,high baseline LMR and low baseline level of CA19 -9 were associated with better prognosis. Disease control rate （DCR） and progression - free survival （ PFS） of the mCRC patients who received maintenance treatment with high baseline NLR were better than patients with low base-line NLR. PFS of the mCRC patients who received maintenance treatment with high baseline LMR were better than pa-tients with low baseline LMR. Conclusion： Histological differentiated degree, baseline level of CA19 -9, baseline NLR and baseline LMR were significant prognostic factors for mCRC patients who received maintenance treatment af-ter standard induction chemotherapy, and baseline NLR level can be used as a predictor of therapeutic efficacy for mCRC patients. Patients with high baseline NLR could benefit more from the maintenance treatment than patients with low NLR.