Ⅲ期结肠癌患者术前外周血淋巴细胞与单核细胞比值与其预后的关联

Association of Preoperative Peripheral Blood lymphocyte-to-Monocyte Ratio and Prognosis in Patients with Stage Ⅲ Colon Cancer

探讨Ⅲ期结肠癌患者术前外周血淋巴细胞与单核细胞比值(LMR)对其远期预后的影响。对某肿瘤医院2013年1月—2016年12月收治的110例Ⅲ期结肠癌患者临床资料进行整理分析,根据患者术前LMR水平进行分组,分析患者术前LMR与临床病理因素之间的关系,并通过Cox回归分析Ⅲ期结肠癌患者术前LMR对其远期预后的影响。结果显示,110例Ⅲ期结肠癌患者术前LMR的最佳截点为4.23,其中LMR<4.23组患者58例,LMR≥4.23组患者52例。随访106例患者(96.36%)的3年生存率为89.62%。LSR<4.23组患者3年生存率小于LSR≥4.23组患者(83.64%vs 96.08%,P<0.05)。多因素Cox回归分析结果显示肿瘤部位、肿瘤大小及LMR为影响Ⅲ期结肠癌患者预后的因素,其HR(95%CI)分别为2.119(1.347~3.333)、1.259(1.019~1.555)及1.693(1.112~2.574)。Ⅲ期结肠癌患者术前LMR可能是预测其预后效果的独立因素,临床治疗时可通过恢复和提高LMR来改善Ⅲ期结肠癌患者预后状况及延长生存时间。

To analyze the effect of preoperative peripheral blood lymphocyte-to-monocyte ratio(LMR)of patient with stage Ⅲ colon cancer on long-term prognosis. Clinical data of 116 patients with stage Ⅲ colon cancer in our hospital from January 2013 to December 2016 were analyzed. Patients were divided into two groups according to the level of LMR, we analyze the relationship between preoperative LMR and clinicopathological factors, and the influence of preoperative LMR on long-term prognosis of stage Ⅲ colon cancer patients was analyzed by Cox regression.Results, The best cut-off point of LMR in ROC curve was 4.23, and 58 cases in LMR<4.23 group, 52 cases in LMR≥4.23 group. Single factor results showed that the LMR was lower in patients with right-side colon tumor and tumor ≧ 4 cm and Preoperative malignant embryonic antigen level ≥ 5 μg/L(P<0.05). A total of 106 patients(96.36%) were followed up for 10-36(median 31) months, and the 3-year survival rate was 89.62%.The 3-year survival rate of patients with LMR< 4.23 was 83.64%, and patients with LMR≧ 4.23 was 96.0%, there was a statistically significant difference(P<0.05). Multivariate Cox regression analysis showed that tumor site, tumor size and LMRwere independent factors affecting the prognosis of patients with stage Ⅲ colon cancer(P<0.05).Conclusion, Preoperative LMR may be an independent factor to predict the prognosis of patients with stage Ⅲ colon cancer. Therefore, the prognosis and survival time of patients with stage Ⅲ colon cancer can be improved by restoring and improving their liver function.