术前外周血NLR和PLR在结直肠癌预后评估中的价值

目的:探讨术前外周血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)对行结直肠癌根治术后患者预后的预测价值。方法:回顾性分析2007年至2012年就诊于湖南省常德市第一人民医院普外科行根治性手术且术后,随访资料完整的237例结直肠癌患者的临床资料。用ROC曲线确定NLR和PLR的Cut-off值后,分为高NLR/PLR组和低NLR/PLR组,比较两组患者的术后总体生存期。结果:NLR和PLR的Cut-off值分别是5. 26和169. 18;与低NLR水平患者相比较,高NLR水平患者的总体生存期明显低于低NLR水平患者(χ2=34. 252,P<0. 001);与低PLR水平患者相比较,高PLR水平患者的总体生存期明显低于低PLR水平患者(χ2=28. 698,P<0. 001); COX单因素回归分析或多因素回归分析均支持NLR (HR=5. 493,95%CI:2. 891～10. 437,P<0. 001; HR=3. 508,95%CI:1. 675～7. 345,P=0. 001)或PLR(HR=5. 094,95%CI:2. 624～9. 887,P<0. 001; HR=2. 092,95%CI:1. 006～4. 348,P=0. 048)可能是评判结直肠癌预后的独立风险因素。结论:NLR和PLR可用于评估结直肠癌患者的预后,NLR≥5. 26或PLR≥169. 18提示预后差。

Value of pre-operative NLR and PLR in prognosis evaluation of colorectal cancer

Objective:To investigate the value of pre-operative neutrophil-to-lymphocyte ratio(NLR)and platelet-to-lymphocyte ratio(PLR)in the prognosis evaluation of colorectal cancer.Methods:The clinical data of 237 patients with colorectal cancer who were admitted to the First People′s Hospital of Changde City,Hunan Province from 2007 to 2012 were retrospectively analyzed.The ROC curves were used to determine the Cut-off values of NLR and PLR.The patients were divided into high NLR/PLR group and low NLR/PLR group.The overall survival was compared between the two groups.Results:The cut-off values of NLR and PLR were 5.26 and 169.18,respectively.The overall survival of patients with high NLR was significantly lower than that of patients with low NLR(χ^2=34.252,P<0.001),and the patients with high PLR had significantly lower overall survival than those with low PLR(χ^2=28.698,P<0.001).The results of COX univariate regression analysis or multivariate regression analysis supported that NLR(HR=5.493,95%CI:2.891-10.437,P<0.001;HR=3.508,95%CI:1.675-7.345,P=0.001)or PLR(HR=5.094,95%CI:2.624-9.887,P<0.001;HR=2.092,95%CI:1.006-4.348,P=0.048)may be an independent risk factor for prognosis of colorectal cancer.Conclusion:NLR and PLR can be used to assess the prognosis of patients with colorectal cancer,NLR≥5.26 or PLR≥169.18 suggested a poor prognosis.