NLR和PLR预测经TACE治疗的原发性肝癌患者预后的价值初步分析*

目的 探讨应用中性粒细胞/淋巴细胞比值（NLR）和血小板/淋巴细胞比值（PLR）预测经动脉导管化学栓塞（TACE）治疗的原发性肝癌（PLC）患者预后的价值。方法 回顾性分析2012年8月~2014年8月我院肝胆外科收治的98例PLC患者,均接受TACE治疗。采用多因素回归分析影响3 a生存率的因素,并绘制受试者工作特征曲线（ROC）判断NLR和PLR的预测价值。结果 98例经TACE治疗的PLC患者1 a、2 a和3 a生存率分别为53.1%、42.9%和39.8%;NLR≤1.82组1 a、2 a和3 a生存率分别为73.9%、56.5%和52.2%,而NLR>1.82组则分别为46.7%、38.7%和36.0%（P<0.05）;PLR≤95.65组患者1 a、2 a和3 a 生存率分别为70.0%、60.0%和53.3%,而PLR>95.65组则分别为45.6%、35.3%和33.8%（P<0.05）;多因素分析结果显示,肿瘤个数≥2个、肿瘤直径>50 mm和NLR>1.82预示PLC患者在TACE术后预后较差,均为影响患者术后生存的独立危险因素。结论 在PLC患者行TACE术前应评估NLR水平,其水平高者,可能预后差。该方法简便易行,但需要扩大验证。

Application of neutrophil/lymphocyte ratio and platelet/lymphocyte ratio in forecasting prognosis of patients with primary liver cancer underwent TACE

Objective To investigate the application of neutrophil/lymphocyte ratio（NLR） and platelet/ lymphocyte ratio （PLR） in forecasting prognosis of patients with primary liver cancer （PLC） underwent transcatheter arterial chemoembolization（TACE）. Methods A retrospective analysis of 98 patients with PLC was made, and the patients were recruited in our hospital between August 2012 and August 2014. All of them received TACE,and followed-up for three years. The factors influencing 3-year survival rate was estimated by multivariate Logistic analysis, and the receiver operating characteristic curve（ROC） was calculated to determine the efficacy of NLR and PLR in forecasting the patients’ prognosis. Results The 1,2 and 3 year survival rates in the 98 patients with PLC after TACE treatment were 53.1%,42.9% and 39.8%;the 1,2 and 3 year survival rates in 23 patients with NLR≤1.82 were 73.9%,56.5% and 52.2%,while they were 46.7%,38.7% and 36.0%,respectively,（P<0.05） in 75 patients with NLR>1.82;the 1,2 and 3 year survival rates in 30 patients with PLR≤95.65 were 70.0%,60.0% and 53.3%,while they were 45.6%,35.3% and 33.8%,respectively,（P<0.05） in 68 patients with PLR>95.65; multivariate Logistic analysis showed that tumor number≥2,tumor diameter >50 mm and NLR>1.82 were the independent factors that would influence the patients’ prognosis. Conclusion The NLR should be assessed before TACE in patients with PLC,which is a easy marker to obtain and might be useful in clinical practice.