术前外周血中性粒细胞/ 淋巴细胞比值在结直肠癌预后中的意义

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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）在结直肠癌患者预后评估中的价值。方法回顾性分析2012年4月～2016年12月在洛阳市中心医院胃肠外科接受手术治疗的174 例患者的临床资料，根据患者术前外周血NLR 将其分为低NLR 组（≤3.96，n=122）组和高NLR 组（＞3.96，n=52）。比较两组患者的临床病理特征，采用Kaplan-Meier 法进行总生存时间分析，Log-rank 检验比较各组的生存情况，Cox 回归分析筛选结直肠癌的独立预后因素。结果两组患者的性别、肿瘤部位、肿瘤大小比较，差异无统计学意义（P＞0.05）；两组患者的肿瘤浸润深度、淋巴结转移、TNM 分期及肿瘤分化情况比较，差异有统计学意义（P＜0.05）。高NLR 组表现为肿瘤浸润更深，淋巴结转移率更高，TNM 分期更晚，分化程度更低。高NLR 组患者1、3、5年的生存率均分别低于低NLR组，差异有统计学意义（P＜0.01）。NLR、淋巴结转移、TNM 分期均是影响结直肠癌患者预后的独立危险因素（P＜0.05）。结论 NLR 是结直肠癌的独立预后因素，NLR＞3.96 的结直肠癌患者预后不良。

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	王皇建
	韩保卫
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	寇玉

关键词 ：结直肠肿瘤, 中性粒细胞/淋巴细胞比值, 预后, 回顾分析

Abstract：Objective To investigate the value of preoperative peripheral blood neutrophil/lymphocyte ratio (NLR) in the prognosis evaluation of patients with colorectal cancer.Methods The clinical data of 174 patients who underwent surgery in the Department of Gastrointestinal Surgery from Luoyang Central Hospital from April 2012 to December 2016 were retrospectively analyzed.According to the preoperative peripheral blood NLR, the patients were divided into low NLR group (≤3.96, n=122) and high NLR group (＞3.96, n=52).The clinicopathological features of the two groups were compared.Kaplan-Meier method and Log-rank test was used to analyze the overall survival time and compare survival situation of the two groups.Cox regression was used to screen the independent prognostic factors for colorectal cancer.Results There were no significant differences in gender, tumor location and tumor size between the two groups(P＞0.05).There were significant differences in tumor infiltration depth, lymph node metastasis, TNM stage and tumor differentiation between the two groups (P＜0.05).In the high NLR group, the tumor infiltration was deeper, the lymph node metastasis rate was higher, the TNM stage was later, and the degree of differentiation was lower.The survival rates of patients in the high NLR group were lower than those in the low NLR group in 1, 3, and 5 years, respectively,and the differences were statistically significant (P＜0.01).NLR, lymph node metastasis, and TNM stage are independent risk factors for the prognosis of colorectal cancer patients (P ＜0.05).Conclusion NLR is an independent prognostic factor for colorectal cancer, and patients with colorectal cancer with NLR＞3.96 have a poor prognosis.

Key words： Colorectal neoplasms Neutrophil/lymphocyte ratio Prognosis Retrospective analysis

基金资助:河南省洛阳市科技计划医疗卫生项目（1721001 A-6）

通讯作者: 韩保卫（1971-），男，主任医师，硕士生导师，副院长，研究方向：胃肠肿瘤

作者简介: 王皇建（1990-），男，2016年在读硕士研究生，研究方向：胃肠道肿瘤基础与临床研究

引用本文:

王皇建；韩保卫；王云帅；寇玉. 术前外周血中性粒细胞/ 淋巴细胞比值在结直肠癌预后中的意义[J]. 中国当代医药, 2019, 26(12): 16-19.
WANG Huang-jian；HAN Bao-wei； WANG Yun-shuai；KOU Yu. Significance of preoperative peripheral blood neutrophil/lymphocyte ratio in the prognosis of colorectal cancer. 中国当代医药, 2019, 26(12): 16-19.

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http://dangdaiyiyao.com/CN/ 或 http://dangdaiyiyao.com/CN/Y2019/V26/I12/16

[1]	Chen WQ，Zheng RS，Peter D，et al.Cancer statistics in China，2015[J].CA：Cancer J Clin，2016，66（2）：115-132.
[10]	Fridlender ZG，Sun J，Mishalian I，et al.Transcriptomic analysis comparing tumor-associated neutrophils with granulocyt icmyeloid-derived suppress or cells and normal neutrophils[J].PLoS One，2012，7（2）：e31524.
[11]	史敬东，钟志强，李有国，等.结直肠癌初治患者外周血中性粒细胞与淋巴细胞比值临床病理特征的关系及其预后价值分析[J].癌症进展，2017，15（6）：709-712.
[12]	张丽，刘芳芳，付丽.肿瘤间质浸润淋巴细胞在乳腺癌中的意义及评价方法[J].中华病理学杂志，2016，45（4）：282-284.
[13]	Malietzis G，Giacometti M，Askari Aet al.A preoperative neutrophil to lymphocyte ratio of 3 predicts disease-free survival after curative elective colorectal cancer surgery[J].An Surg，2014，260（2）：287-292.
[14]	Choi WJ，Cleghorn MC，Jiang H，et al.Preoperative neutrophil-to-lymphocyte ratio is a better prognostic serum biomarker than platelet-to-lymphocyte ratio in patients undergoing resection for nonmetastatic colorectal cancer[J].Ann Surg Oncol，2015，22（S3）：603-613.
[15]	陈卓，顾飞腾，朱建林，等.术前外周血中性粒细胞和淋巴细胞比值与结直肠癌术后病理的相关性分析[J].临床医药文献电子杂志，2017，4（82）：16 193-16 195.
[16]	庄肃非.中性粒细胞/淋巴细胞比值与结直肠癌临床病理特征关系的研究[D].银川：宁夏医科大学，2016.
[17]	Shibutani M，Maeda K，Nagahara H，et al.The prognostic significance of a postoperative systemic inflammatory response in patients with colorectal cancer[J].World J Surg Oncol，2015，13：194.
[18]	Balde AI，Fang S，He L，et al.Propensity score analysis of recurrence for neutrophil-to-lymphocyte ratio in colorectal cancer[J].J Surg Res，2017，219：244-252.
[19]	Kishi Y，Kopetz S，Chun YS，et al.Blood neutrophil-tolymphocyte ratio predicts survival in patients with colorectal liver metastases treated with systemic chemotherapy[J].Ann Surg Oncol，2009，16（3）：614-622.
[20]	Stotz M，Pichler M，Absenger G，et al.The preoperative lymphocyte to monocyte ratio predicts clinical outcome in patients with stage Ⅲ colon cancer[J].Br J Cancer，2014，110（2）：435-440.
[2]	万德森.结直肠癌流行病学与预防[J].中国中西医结合外科杂志，2011，17（1）：3-7.
[3]	Pine JK，Morris E，Hutchins GG，et al.Systemic neutrophilto-lymphocyte ratio in colorectal cancer：the relationship to patientsurvival，tumour biology and local lymphocytic response to tumour[J].Br J Cancer，2015，113（2）：204-211.
[4]	Kesler CT，Liao S，Munn LL，et a l.Lymphatic vessels in health and disease[J].Wiley Interdiscip Rev Syst Biol Med，2013，5（1）：111-124.
[5]	Lee BS，Lee SH，Son JH，et al.Neutrophil-lymphocyte ratio predicts survival in patients with advanced cholangiocarcinoma on chemotherapy[J].Cancer Immunol Immunother，2016，65（2）：141-150.
[6]	陈创奇，方乐堃，马晋平，等.结直肠癌2042 例临床病理特点及预后回归分析[J].中华医学杂志，2010，90（26）：1804-1807.
[7]	Balkwill F，Mantovani A.Inflammation and cancer：back to Virchow?[J].Lancet，2001，357（9255）：539-545.
[8]	王战波，王勇，阮翊.术前外周血中性粒细胞和淋巴细胞比值在结直肠癌预后中的意义[J].中华临床医师杂志（电子版），2016，10（6）：785-789.
[9]	江慧洪，王晖，李阿建，等.中性粒细胞/淋巴细胞比值对局部进展期结直肠癌患者预后的影响[J].中华胃肠外科杂志，2017，20（5）：550-554.