术前外周血中性粒细胞与淋巴细胞比值对结肠癌患者预后的影响

Influence of preoperative peripheral blood neutrophil to lymphocyte ratio on prognosis in patients with colon cancer

目的探讨术前外周血中性粒细胞与淋巴细胞比值(NLR)对结肠癌患者预后的影响。方法回顾性分析197例行结肠癌根治术的Ⅰ~Ⅲ期结肠癌患者的临床资料,根据受试者工作特征曲线确定的NLR最佳截断值,将患者分为高NLR(≥2.75)组93例和低NLR(<2.75)组104例。比较两组患者间临床病理特征及生存率。采用Cox回归模型分析患者预后影响因素。结果与低NLR组比较,高NLR组肿瘤直径更大,组织分化程度和5年生存率更低(均P<0.05)。Cox回归分析显示,癌胚抗原水平、分化程度和NLR是结肠癌患者预后的独立危险因素(均P<0.05)。结论 NLR升高的结肠癌患者预后更差,其可结合组织分化程度、癌胚抗原等指标对患者预后进行评估。

Objective To investigate the influence of preoperative peripheral blood neutrophil to lymphocyte ratio（ NLR） on the prognosis in patients with colon cancer. Methods The clinical data of 197 patients with stage Ⅰ-Ⅲ colon cancer undergoing radical surgery were retrospectively analyzed. The receiver operating characteristic curve was used to determine the optimal cutoff value of NLR,according to which patients were divided into high NLR（ NLR≥2. 75） group（ n = 93） and low NLR（ NLR〈2. 75） group（ n = 104）. The clinicopathological features and survival rate were compared between the two groups. The Cox regression model was used to analyze the influencing factors of prognosis. Results Compared with the low NLR group,the high NLR group had greater tumor diameter,poorer tissue differentiation and lower 5-year survival rate（ all P〈0. 05）. The Cox regression analysis showed that carcinoembryonic antigen（ CEA） level,differentiation degree and NLR were independent risk factors for the prognosis of patients with colon cancer（ all P〈0. 05）. Conclusion Poorer prognosis is observed in the colon cancer patients with elevated NLR. Besides NLR,the prognosis of the patients should be evaluated using the indices including tissue differentiation degree and CEA.