血小板淋巴细胞比值、中性粒细胞淋巴细胞比值与晚期结肠癌患者预后关系的研究

Relationship between platelet lymphocyte ratio,neutrophil lymphocyte ratio and prognosis in patients with advanced colon cancer

目的研究血小板淋巴细胞比值(Platelet-to-lymphocyte ratio,PLR)、中性粒细淋巴细胞比值(Neutrophil-to-lymphocyte ratio,NLR)与晚期结肠癌患者预后的关系。方法回顾分析新疆医科大学第一附属医院胃肠肿瘤外科2014年1月-2020年12月收治的136例晚期结肠癌患者临床资料,根据患者PLR和NLR的高低进行分组。分析比较两组患者PLR、NLR和总生存率(Overall survival,OS)的关系;采用Kaplan-Meier法绘制生存曲线;组间比较采用Log rank检验;采用Cox比例风险回归模型评价患者预后不良的危险因素。结果共136例晚期结肠癌患者纳入本研究。高、低PLR组的中位OS分别为15.0和35.0个月,风险率(Hazard ratio,HR):3.775,95%置信区间(Confidence interval,CI:2.393~5.956,P<0.001);高、低NLR组患者的中位OS分别为14.0个月和30.0个月(HR:2.314,95%CI:1.613~3.319,P<0.001)。多因素分析表明,PLR、NLR和发病部位及临床分期为影响患者生存的独立预后因素,其中高PLR的患者死亡率几乎是低PLR患者的3倍(HR:2.760,95%CI:1.708~4.462,P<0.001);与低NLR患者相比,高NLR的患者死亡率增大(HR:1.925,95%CI:1.307~2.835,P<0.001)。结论PLR、NLR是预测晚期结肠癌患者预后的独立因素。

ObjectiveTo investigate the prognostic value of pre-treatment platelet-to-lymphocyte ratio(PLR)and neutrophil-to-lymphocyte ratio(NLR)in patients with advanced colon cancer.MethodsClinical data of 136 patients with advanced colon cancer in the hospital from January 1,2014 to December 31,2020 was analysis retrospectively.All patients were divided into high or low PLR and NLR groups according to the value of PLR and NLR.The relationship between PLR,NLR and overall survival(OS)was analyzed and compared between the two groups;Kaplan-Meier method was used to draw survival curve;Log rank test was used to compare and analyze between the groups;Cox proportional risk regression model was used to evaluate the risk factors of poor prognosis of the patients.ResultsA total of 136 patients with advanced colon cancer were included in the retrospective study.The median OS of the high and low PLR groups were 15.0 and 35.0 months,respectively(HR:3.775,95%CI:2.393~5.956,P<0.001);and median OS were 14.0 and 30.0 months for high and low NLR groups,respectively(HR:2.314,95%CI:1.613~3.319,P<0.001).Multivariate analysis showed that PLR,NLR,location and clinical stage were independent prognostic factors affecting the patient′s survival.Patients in high PLR group had a mortality rate nearly three times than the patients in low PLR group(HR:2.760,95%CI:1.708~4.462,P<0.001).Meanwhile,the mortality rate for the patients with high NLR were also almost twice as compared to the patients with low NLR(HR:1.925,95%CI:1.307~2.835,P<0.001).ConclusionPLR and NLR were two independent prognostic risk factors for the patients with advanced colon cancer.