术前NLR、PLR、RDW检测对结直肠癌预后及复发转移的应用价值

The value of preoperative NLR,PLR,and RDW detection in the prognosis,recurrence,and metastasis of colorectal cancer

目的分析术前中性粒细胞计数与淋巴细胞计数比值(NLR)、血小板计数与淋巴细胞计数比值(PLR)、红细胞分布宽度(RDW)检测对结直肠癌预后及复发转移的应用价值。方法选取自2018年3月至2022年1月酒泉市中医院收治的131例结直肠癌患者作为研究对象,将其纳入观察组;选取同期健康体检者72名纳入对照组。检测观察组术前及对照组体检时外周血NLR、PLR及RDW指标,比较两组NLR、PLR及RDW变化情况,根据结直肠癌患者预后情况分为预后不良组和预后良好组,并分析NLR、PLR及RDW指标与结直肠癌患者预后及复发转移的关系;比较观察组复发、转移及死亡不同预后NLR、PLR、RDW水平变化。结果观察组患者外周血NLR、PLR及RDW均高于对照组,差异具有统计学意义(P<0.05)。预后不良组29例(肿瘤复发13例、肿瘤转移12例、死亡4例),预后良好组102例。预后良好与预后不良组患者的性别、年龄、病理类型、肿瘤部位比较,差异无统计学意义(P>0.05)。两组患者的TNM分期、分化程度、淋巴结转移情况、NLR、PLR及RDW水平比较,差异具有统计学意义(P<0.05)。Logistic回归分析结果显示,TNM分期在Ⅲ~Ⅳ期、处于低分化、有淋巴结转移及NLR、PLR、RDW异常升高是影响结直肠癌患者预后不良的独立危险因素(P<0.05)。NLR、PLR、RDW水平:肿瘤复发组<肿瘤转移组<死亡组,差异具有统计学意义(P<0.05)。结论结直肠癌患者术前NLR、PLR及RDW指标均有所升高,NLR、PLR及RDW异常升高是影响患者预后不良的独立危险因素。详细记录结直肠癌患者三指标变化,有利于监测患者病情、评估肿瘤复发转移情况。

Objective To analyze the application value of preoperative neutrophil to lymphocyte ratio(NLR),platelet to lymphocyte ratio(PLR),and red blood cell distribution width(RDW)detection for prognosis,recurrence,and metastasis of colorectal cancer.Methods A total of 131 patients with colorectal cancer admitted to Jiuquan Hospital of Traditional Chinese Medicine from March 2018 to January 2022 were selected as subjects and included into the observation group.Seventy⁃two healthy subjects in the same period were included in the control group.The peripheral blood NLR,PLR and RDW indicators in the observation group and the control group were detected during the preoperative physical examination,and the changes of NLR,PLR and RDW in the two groups were compared.According to the prognosis of colorectal cancer pa⁃tients,the two groups were divided into the poor prognosis group and the good prognosis group,and the levels of NLR,PLR and RDW in different prognosis of recurrence,metastasis and death were compared in the obser⁃vation group.Results The peripheral blood NLR,PLR and RDW in the observation group were higher than those in the control group,and the difference was statistically significant(P<0.05).In this study,there were 29 patients in the poor prognosis group(13 patients with tumor recurrence,12 patients with tumor metastasis,and 4 patients with death),and 102 patients in the good prognosis group.There was no significant difference in gender,age,pathological type,and tumor location between the good prognosis group and the poor progno⁃sis group(P>0.05).There were statistically significant differences in TNM stage,differentiation degree,lymph node metastasis,NLR,PLR and RDW levels between the two groups(P<0.05).The results of logistic regression analysis showed that TNM staging in stagesⅢ~Ⅳ,low differentiation,lymph node metastasis,and abnormal elevation of NLR,PLR and RDW were independent risk factors for poor prognosis in colorectal can⁃cer patients(P<0.05).Conclusion Preoperative NLR,PLR and RDW indicators were elevated in patients with colorectal cancer,and abnormal elevation of NLR,PLR and RDW was an independent risk factor for poor prognosis.Detailed records of the changes of the three indicators in patients with colorectal cancer are con⁃ducive to monitoring the patient's condition and assessing tumor recurrence and metastasis.