原发性肝癌术前中性粒细胞/淋巴细胞比值、血小板/淋巴细胞比值和甲胎蛋白对预后的评估分析

Preoperative neutrophil/lymphocyte ratio, platelet/lymphocyte ratio, and alpha-fetoprotein evaluation of the prognosis of primary liver cancer

目的 探讨原发性肝癌术前中性粒细胞/淋巴细胞比值(NLR)、血小板/淋巴细胞比值(PLR)、甲胎蛋白(AFP)对预后的评估价值。方法 选取2018年1月至2020年1月本院收治的80例原发性肝癌患者作为观察组,另选取同期于本院体检的80名健康人群作为对照组。比较两组术前血清NLR、PLR、AFP水平、观察组手术前后NLR、PLR、AFP水平、术后随访期间观察组复发与无复发患者血清指标NLR、PLR、AFP水平;分析肝癌患者术后预后与术前血清指标的相关性及血清NLR、PLR、AFP对肝癌患者术后预后的检测价值。结果 术前,观察组NLR、PLR、AFP水平高于对照组(P<0.05)。术后1周及术后1个月,观察组NLR、PLR、AFP水平均低于术前(P<0.05)。随访期间,观察组出现复发16例(20.00%),复发患者术前NLR、PLR、AFP水平均高于未复发患者(P<0.05)。Spearman相关性分析结果显示,原发性肝癌患者术前NLR、PLR、AFP水平与患者治疗后疾病复发率呈正相关(P<0.05)。术前NLR、PLR及AFP受试者工作曲线(ROC)分析结果显示,NLR、PLR及AFP曲线下面积分别为0.781、0.859、0.858,对应最佳截断点为0.536、0.506、0.453。结论 原发性肝癌术前NLR、PLR、AFP水平与治疗后的预后情况具有相关性,可作为患者预后的判断指标。

Objective To investigate the prognostic value of neutrophil/lymphocyte ratio(NLR), platelet/lymphocyte ratio(PLR), and alpha-fetoprotein(AFP) of primary liver cancer preoperative. Methods 80 patients with primary liver cancer admitted to our hospital from January 2018 to January 2020 were selected as the observation group, and 80 healthy people who received physical examination in our hospital during the same period were selected as the control group. The preoperative serum NLR, PLR, AFP levels of the two groups, the preoperative and postoperative NLR, PLR, AFP levels of the observation group, and the serum indexes NLR, PLR, AFP levels of the patients with recurrence and those without recurrence in the observation group during the postoperative follow-up were compared, the correlation between postoperative prognosis of patients with liver cancer and preoperative serum indexes was analyzed, and the detection value of serum NLR, PLR and AFP for postoperative prognosis of patients with liver cancer was analyzed.Results The levels of NLR, PLR and AFP in the observation group were higher than those in the control group before operation(P<0.05). The levels of NLR, PLR, and AFP in the observation group were lower than those before operation 1 week after operation and 1 month after operation(P<0.05). During the follow-up period, 18 patients had recurrence(20.00%), the preoperative NLR, PLR, and AFP levels of the patients who relapsed were higher than those who did not relapse(P<0.05). The results of Spearman correlation analysis showed that the levels of NLR, PLR and AFP in patients with primary liver cancer before surgery were positively correlated with the recurrence rate of the disease after treatment(P<0.05). The receiver operating curve(ROC) curve analysis of preoperative NLR, PLR and AFP showed that the areas under the curves of NLR, PLR and AFP were 0.781, 0.859, and 0.858,respectively, and the corresponding best cut-off points were 0.536, 0.506 and 0.453. Conclusion The levels of NLR, PLR and AFP before the operation of primary liver cancer are correlated with the prognosis of patients after treatment, and can be used as indicators for the prognosis of patients.