术前NLR、PLR结合CEA表达水平与结直肠癌TNM分期相关性分析

Analysis of the Correlation Between the Preoperative Expression Levels of NLR,PLR Combined with CEA and TNM Staging in Colorectal Cancer

目的研究结直肠癌患者术前中性粒细胞/淋巴细胞比值(neutrophil-to-lymphocyte ratio,NLR)、血小板/淋巴细胞比值(platelet-to-lymphocyte ratio,PLR)和癌胚抗原(carcino-embryonic antigen,CEA)与结直肠癌TNM分期的相关性,评估NLR、PLR、CEA对于结直肠癌分期的预测价值.方法运用回顾性分析方法,收集了2018年7月-2019年7月在苏州大学附属第一医院行结直肠癌手术患者的病例资料,运用SPSS软件对数据进行F检验、秩和检验等统计学处理分析.结果96例结直肠癌患者中Ⅰ期9例、Ⅱ期36例、Ⅲ期32例、Ⅳ期19例,平均年龄分别为(63.22±9.03)岁、(63.25±12.84)岁、(65.00±11.03)岁、(63.32±7.40)岁(P=0.921),NLR的中位数分别为1.79、2.87、2.05、2.67(P=0.019),PLR的中位数分别为129.57、161.94、158.14、151.41(P=0.792),CEA的中位数分别为2.89、4.24、3.76、17.80(P=0.01).组间比较发现不同分期间的NLR水平(P=0.019)与CEA水平(P=0.01)差异有统计学意义;年龄(P=0.921)与PLR(P=0.792)差异无统计学意义.对96例病例进行T、N、M分期,组间比较发现不同T分期和N分期间的NLR、PLR和CEA表达水平差异无统计学意义(P>0.05);不同M分期间的CEA中位数分别为3.70和17.80,差异有统计学意义(P=0.001).Spearman相关性分析结果相关系数CEA>NLR,CEA水平与结直肠癌TNM分期呈现明显正相关.结论NLR、CEA与结直肠癌TNM分期有明显正相关,可以作为临床术前评估结直肠TNM一个比较好的指标.

Objective To investigate the correlation between preoperative neutrophil-to-lymphocyte ratio(NLR),platelet-to-lymphocyte ratio(PLR)and carcino-embryonic antigen(CEA)and TNM staging of patients with colorectal cancer(CRC),and to evaluate the predictive value of NLR,PLR and CEA for staging of CRC.Methods A retrospective analysis method was used to collect cases of CRC surgery in the First Affiliated Hospital of Soochow University from July 2018 to July 2019.The data were analyzed by F testing method and rank-sum test.Results Among 96 patients with CRC,9 were in stageⅠ,36 in stageⅡ,32 in stageⅢ,and 19 in stageⅣ.The mean ages were(63.22±9.03),(63.25±12.84),(65.00±11.03),and(63.32土7.40)(P=0.921).The median NLR was 1.79,2.87,2.05,and 2.67(P=0.019),the median PLR was 129.57,161.94,158.14,and 151.41(P=0.792),and the median CEA was 2.89,4.24,3.76,and 17.8(P=0.01).The NLR levels(P=0.019)and CEA levels(P=0.01)were statistically different between the groups.There was no significant difference between age(P=0.921)and PLR(P=0.792).T,N,and M staging were performed in 96 cases.There was no significant difference in NLR,PLR,and CEA levels between different T and N points(P>0.05).The median CEA of different M points was 3.70 and 17.80,respectively,the difference was statistically significant(P=0.001).Spearman correlation analysis results correlation coefficient:CEA>NLR.CEA level and CRC TNM staging showed a significant positive correlation.Conclusion NLR,CEA and TNM staging of CRC are related,which can be used as a good indicator for preoperative evaluation of CRC TNM staging.