术前外周血中性粒细胞/淋巴细胞比值对高龄结肠癌患者预后的评估价值
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朱磊, Email: zhulei19862012@126.com

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Prognostic value of preoperative peripheral blood neutrophil-lymphocyte ratio in elderly patients after radical operation for colon cancer
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    摘要:

    目的:探讨术前外周血中性粒细胞/淋巴细胞比值(NLR)对高龄(≥75岁)结肠癌患者根治术后的预后评估价值。 方法:收集2008年1月—2013年1月间在辽河油田总医院普通外科接受根治性手术的67例75岁以上结肠癌患者的临床资料,分析患者术前外周血NLR与临床病理因素及生存率的关系。 结果:根据NLR的ROC曲线截点值(2.98)将患者分为低NLR组(NLR<3)和高NLR组(NLR≥3),其中低NLR组44例,高NLR组23例。与低NLR组比较,高NLR组肿瘤分化程度低(P=0.040)、淋巴结转移率高(P=0.018)、TNM分期高(P=0.008)、CEA水平高(P=0.026);全组患者术后3年总生存率为62.7%,其中低NLR组和高NLR组术后3年生存率分别为72.7%和43.5%,两组差异有统计学意义(P<0.05)。单因素分析显示,术前NLR连同肿瘤分化程度、肿瘤分期、淋巴结转移和CEA水平与患者术后生存有关(均P<0.05)。 结论:术前NLR对高龄结肠癌患者根治术后的预后判断有一定价值,高NLR者预后较差。

    Abstract:

    Objective: To investigate the value of preoperative peripheral blood neutrophil-lymphocyte ratio (NLR) in estimating the prognosis in elderly patients (75 years of age and older) after radical surgery for colon cancer. Methods: The clinical data of 67 colon cancer patients over 75 years of age undergoing radical surgery in Department of General Surgery of Liaohe Oil Field General Hospital from January 2008 to January 2013 were collected. The relations of preoperative NLR values of the patients with the clinicopathologic factors and postoperative survival rates were analyzed. Results: According to the cut-off point of NLR (2.98), the patients were divided into low NLR group (NLR<3) and high NLR group (NLR≥3), with 44 cases in the former and 23 cases in the latter. The degree of tumor differentiation was poorer (P=0.040), lymph node metastasis rate was higher (P=0.018), TNM stage was more advanced (P=0.008) and CEA level was higher (P=0.026) in high NLR group than those in low NLR group. The overall postoperative 3-year survival rate in the whole group of patients was 62.7%, which in low NLR group and high NLR group was 72.7% and 43.5% respectively, and the difference had statistical significance (P<0.05). Univariate analysis showed that the preoperative NLR value together with the degree of tumor differentiation, TMN stage, lymph nodes metastasis and CEA level were significantly associated with the postoperative survival of the patients (all P<0.05). Conclusion: Preoperative NLR has certain value in prognostic estimation for elderly colon cancer patients after radical surgery, and those with high NLR level may face an unfavorable prognosis.

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朱磊|阚丽丽|王俊平|徐亮|吴杰|牟春露.术前外周血中性粒细胞/淋巴细胞比值对高龄结肠癌患者预后的评估价值[J].中国普通外科杂志,2017,26(4):501-505.
DOI:10.3978/j. issn.1005-6947.2017.04.016

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  • 收稿日期:2016-10-13
  • 最后修改日期:2017-03-05
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  • 在线发布日期: 2017-04-15