术前外周血纤维蛋白原水平联合血小板与淋巴细胞比值的评分对结直肠癌中预后的评估价值

The predictive value of preoperative fibrinogen level in peripheral blood combined with platelet-to-lymphocyte ratio in the prognosis of colorectal cancer

目的结直肠癌(CRC)手术切除后的局部复发或远处转移仍直接影响着CRC患者的预后。文中探讨术前外周血纤维蛋白原(Fbg)水平联合血小板与淋巴细胞比值(PLR)对CRC预后的临床意义。方法分析2013年1月至2015年12月江苏大学附属武进医院经病理确诊,且行手术切除的108例CRC患者临床病理特征资料。采用ROC曲线确定Fbg和PLR阈值,并根据Fbg联合PLR评分(F-PLR)原则将患者进行分组。分析不同评分与CRC患者病理特征资料及预后的关系。结果PLR在肿瘤位于左右半部位的差异有统计学意义(P<0.05),而Fbg和F-PLR在年龄、肿瘤部位及是否淋巴结转移方面差异无统计学意义(P>0.05)。用Cox回归行多因素分析显示,F-PLR评分和TNM分期、淋巴结是否转移是影响CRC患者预后的独立危险因素(P<0.05)。结论Fbg和PLR联合的F-PLR评分可作为CRC患者治疗效果及预后的预测指标,可用于指导临床治疗决策及判断预后。

Objective The local recurrence or distant metastasis of colorectal cancer(CRC)after surgical resection still directly affects the prognosis of CRC patients.This study aims to investigate the clinical significance of preoperative peripheral blood fibrinogen(Fbg)level combined with platelet-to-lymphocyte ratio(PLR)in the prognosis of CRC.Methods The clinicopathological characteristics of 108 CRC patients who were diagnosed by pathology and underwent surgical resection in Wujin hospital affiliated to Jiangsu University from January 2013 to December 2015 were analyzed.Fbg and PLR thresholds were determined by ROC curve,and the patients were grouped according to Fbg combined with PLR(F-PLR)to analyze the relationship between different F-PLR scores and the clinicopathological characteristics and prognosis of CRC patients.Results PLR showed statistically significant difference in the left and right half of the tumor(P<0.05),while Fbg and f-plr showed no significant difference in age,tumor site and lymph node metastasis(P>0.05).Multivariate analysis using COX regression showed that F-PLR score,TNM stage and lymph node metastasis were independent risk factors for the prognosis of CRC patients(P<0.05).Conclusion The F-PLR score(Fbg and PLR combined)can be used as a predictor of treatment effect and prognosis of CRC patients to guide clinical treatment decisions and prognoses.