术前LSR、NLR及PLR检测评估结直肠癌预后的应用价值

The value of preoperative LSR,NLR and PLR detection in evaluating the prognosis of colorectal cancer

目的探讨术前谷丙转氨酶(ALT)/谷草转氨酶(AST)比值(LSR)、中性粒细胞(NEU)/淋巴细胞计数(LYM)比值(NLR)及血小板计数(PLT)与LYM比值(PLR)检测在评估结直肠癌预后中的应用价值。方法选取2015年3月至2018年2月首都医科大学附属北京世纪坛医院收治的92例结直肠癌患者作为观察组,选取同期本院97例健康体检者作为对照组。比较两组LSR、NLR、PLR水平,通过受试者工作特征曲线(ROC)确定三项指标对结直肠癌患者预后判断的最佳截断值,分析三者与结直肠癌患者病理参数、预后的关系。结果观察组LSR、NLR、PLR水平均高于对照组,差异具有统计学意义(P<0.05)。以总生存时间(OS)为终点,通过ROC曲线计算LSR、NLR、PLR cut-off值分别为2.49、3.31、139.22;灵敏度分别为0.815、0.855、0.797;特异度分别为0.787、0.823、0.785;AUC分别为0.791、0.865、0.745。LSR≥2.49、NLR≥3.31、PLR≥139.22的患者中-低分化、Ⅲ~Ⅵ期、肿瘤直径>3 cm的占比高于LSR<2.49、NLR<3.31、PLR<139.22的患者,差异具有统计学意义(P<0.05)。92例结直肠癌患者随访期间内死亡38例,生存率为58.70%(54/92)。LSR≥2.49、NLR≥3.31、PLR≥139.22的患者死亡率均高于LSR<2.49、NLR<3.31、PLR<139.22的患者,差异具有统计学意义(P<0.05)。结论LSR、NLR、PLR是评估结直肠癌患预后的有效参考指标,临床可通过联合三者检测辅助临床诊断及治疗。

Objective To explore the application value of preoperative alanine transaminase(ALT)/aspartate transaminase(AST)ratio(LSR),neutrophil(NEU)/lymphocyte count(LYM)ratio(NLR),platelet count(PLT)to lymphocyte(LYM)ratio(PLR)detection in evaluating the prognosis of colorectal cancer.Methods 92 patients with colorectal cancer admitted to Beijing Shijitan Hospital,Capital Medical University from March 2015 to February 2018 were selected as the observation group,and 97 healthy patients in the hospital during the same period were selected as the control group.The LSR,NLR,and PLR levels of the two groups were compared,and the receiver operating characteristic curve(ROC)was used to determine the optimal cut-off value of the three indicators for the prognosis of patients with colorectal cancer..The relationship between the three and the pathological parameters and prognosis of colorectal cancer patients was analyzed.Results The levels of LSR,NLR,and PLR in the observation group were higher than those in the control group,and the difference was statistically significant(P<0.05).Taking the overall survival time(OS)as the end point,the cut-off values of LSR,NLR and PLR calculated by ROC curve were 2.49,3.31 and139.22,respectively.The sensitivity were 0.815,0.855,and 0.797;the specificity were 0.787,0.823,0.785,respectively.The AUCs were 0.791,0.865,0.745,respectively.The AUCs were 0.791,0.865,and 0.745,respectively.The proportion of patients with LSR≥2.49,NLR≥3.31,and PLR≥139.22 was higher than that of patients with LSR<2.49,NLR<3.31,and PLR<139.22.The proportion of patients with moderate to poorly differentiated,stageⅢ~Ⅵ,and tumor diameter>3 cm was higher than that of patients with LSR<2.49,NLR<3.31,and PLR<139.22.The difference was statistically significant.Academic significance(P<0.05).Among 92 patients with colorectal cancer,38 died during the follow-up period,and the survival rate was 58.70%(54/92).The mortality of patients with LSR≥2.49,NLR≥3.31,PLR≥139.22 was higher than that of patients with LSR<2.49,NLR<3.31,PLR<139.22,and the difference was statistically significant(P<0.05).Conclusion LSR,NLR,and PLR are effective reference indicators for evaluating the prognosis of patients with colorectal cancer.The combination of the three can be used to assist clinical diagnosis and treatment.