中性粒细胞与淋巴细胞比值对胰腺癌预后的影响

Influence of Neutrophil to Lymphocyte Ratio on the Prognosis of Pancreatic Cancer

目的探讨中性粒细胞计数与淋巴细胞计数比值(neutrophil to lymphocyte ratio,NLR)对胰腺癌患者预后的影响。方法回顾性分析2010年1月~2013年1月105例接受根治性手术的胰腺癌患者病历资料。通过Log-rank单因素分析包括NLR在内的临床病理特征对术后1年生存率及中位生存时间的影响。并通过Cox风险模型将有意义的变量进行多因素分析。结果依据患者术前血常规检查,计算NLR,依据四分位点,分为NLR<2.1、2.1≤NLR<2.8、2.8≤NLR<4.3、NLR≥4.3 4个组,各组患者的术后中位生存时间分别为25、16、11、5个月。NLR<2.1、2.1≤NLR<2.8、2.8≤NLR<4.3 3组1年生存率分别为84.7%、79.8%、36.2%,其中NLR≥4.3组患者1年生存率低于5%,差异有统计学意义(P均<0.05)。多因素分析显示,术前外周血NLR、肿瘤直径、肿瘤分化程度、淋巴结转移、脉管侵犯、肿瘤T分期、远处转移是影响胰腺癌患者预后的独立危险因素(P均<0.05)。结论术前外周血NLR可作为评价胰腺癌患者根治性手术后预后的指标。

Objective To investigate the effect of neutrophil count and lymphocyte count ratio （ Neutrophil to Lymphocyte Ratio, NLR） on the prognosis of patients with pancreatic cancer. Methods Clinical data of 105 patients with pancreatic cancer who underwent radical surgery from January 2010 to January 2013 were analyzed retrospectively. Univariate analysis of Log - rank was used to investigate the effects of clinical pathological features, including NLR, on the 1 year survival rate and median survival time. Multivariate analysis was performed by using Cox risk model. Results according to the results of blood routine examination, preoperative NLR calculation, on the basis of the four sub sites, divided into 2.1, NLR 〈2.1 〈NLR 〈2.8, 2.8 〈NLR 〈4.3, NLR≥4.3, four groups. Each group of pa- tients with postoperative median survival time was 25 months, 16 months, ll and 5 months 1 year survival rate NLR 〈2.1,2. 1 ≤NLR 〈 2.8, 2.8≤NLR〈4.3 were 84.7%, 79.8%, 36.2%, and NLR≥4.3 group, 1 years survival rate was less than 5%. The difference was statistically significant （ P 〈 0.05 ）. Multivariate analysis showed that preoperative peripheral blood NLR, tumor diameter, tumor dif- ferentiation, lymph node metastasis, vascular invasion, tumor T staging and distant metastasis were independent prognostic factors in pa- tients with pancreatic cancer （P 〈 0.05 ）. Conclusion Preoperative peripheral blood NLR can be used as an indicator for evaluating the nroenosis of natients with pancreatic cancer after radical sur,,erv.