中性粒细胞/淋巴细胞比值对Ⅱ期结直肠癌手术预后意义研究

Prognostic significance of neutrophil to lymphocyte ratio in stage Ⅱ colorectal cancer

目的:评估Ⅱ期结肠直肠癌患者手术前后中性粒细胞/淋巴细胞比值的变化对预后的影响。方法:选取Ⅱ期结肠直肠癌手术患者260例,比较手术前后中性粒细胞、淋巴细胞、单核细胞、中性粒细胞/淋巴细胞、淋巴细胞/单核细胞变化。结果:单因素方差分析表明中性粒/淋巴细胞比值高(风险比3.613;95%可信区间1.058~9.445;P=0.004)和淋巴细胞/单核细胞比值低(风险比2.465;95%可信区间1.010~5.880;P=0.048)的患者无病生存期较短,中性粒/淋巴细胞比值高(风险比3.018;95%可信区间1.467~6.207;P=0.003)和淋巴细胞/单核细胞比值低(风险比2.374;95%可信区间1.188~4.474;P=0.014)的患者总生存期较短,多因素方差分析发现中性粒/淋巴细胞比值高是无病生存期较短(风险比3.163;95%可信区间1.058~9.455;P=0.004)和总生存期较短(风险比3.018;95%可信区间1.467~6.207;P=0.003)的独立危险因素。结论:在全身性炎症指标中,中性粒细胞/淋巴细胞比值与Ⅱ期结直肠术后无病生存期和总生存期相关。

Objective：To investigate the prognostic impact of neutrophil to lymphocyte ratio after curative surgery in stage Ⅱ colorectal cancers.Methods：Two hundred sixty patients with stage Ⅱ colorectal cancers who underwent curative surgery were reviewed.Oncologic outcomes were analyzed with neutrophil count,lymphocyte count,monocyte count,neutrophil to lymphocyte ratio（NLR）,and lymphocyte to monocyte ratio.Results：Univariate analysis showed that high NLR [hazard ratio（HR）,3.613;95%confidenceinterval（CI）,1.058-9.445;P=0.004]and low LMR（HR,2.465;95% CI,1.010-5.880;P =0.048）were associated with worse disease-free survival（DFS）,and high NLR（HR,3.018;95% CI,1.467-6.207;P=0.003）and low LMR（HR,2.374;95% CI,1.188-4.474;P=0.014）were associated with worse overall survival（OS）in stage Ⅱ colorectal cancer.Cox multivariate analysis demonstrated that high NLR was independently associated with worse DFS（HR,3.163;95% CI,1.058-9.455;P = 0.004）and OS（HR,3.018;95%CI,1.467-6.207;P=0.003）in stage Ⅱ colorectal cancer.Conclusion：Among the systemic inflammatory markers,NLR is a strong predictor of worse DFS and OS in stage Ⅱ colorectal cancer.