中性粒细胞与淋巴细胞比率变化对结肠癌患者生存率的预测价值

目的探讨中性粒细胞与淋巴细胞比率(NLR)变化对结肠癌患者生存率的预测价值。方法选择结肠癌患者124例进行随访研究,动态观察术前、术后化疗前、化疗后3月外周血NLR水平变化。对患者进行随访,记录随访结果并分析。结果术前外周静脉血NLR范围1.21~5.20,中位数2.95,术后化疗前复查NLR中位数3.02(1.45~5.34),以NLR≥3.82为切值,5例患者NLR出现升高(≥3.82);化疗后复查中位数2.81(1.13~4.98),有7例患者出现NLR下降(3.82),下降率为26.93%(7/26)。术前高NLR患者3年、5年无复发生存率为60.4%、53.6%,显著低于低NLR患者(80.4%、72.5%)(log-rankχ2=8.53,P=0.021)。术后化疗高NLR患者的3年、5年无复发生存率为56.8%、50.3%,显著低于低NLR患者(82.9%、76.5%)(log-rankχ2=9.25,P=0.013)。化疗后3个月高NLR患者的3年、5年无复发生存率为61.2%、54.9%,显著低于低NLR患者(78.6%、70.4%)(log-rankχ2=7.95,P=0.028)。结论 NLR的动态水平变化可以作为结肠癌患者极有价值的预测指标。

Study on the significance of ratio of neutrophils and lymphocytes in prediction of survival rate in patients with colon cancer

Objective To explore the predictive value of neutrophil and lymphocyte ratio（ NLR） for survival rate in patients with colon cancer. Methods A total of 124 patients with colon cancer were followed up before surgery,postoperative period before chemotherapy and 3months after chemotherapy. Levels of NLR in peripheral blood were continuously observed. All patients were followed up and their results were recorded and analyzed. Results The median peripheral blood NLR before surgery was 2. 95（ 1. 21 ～ 5. 20）. The postoperative median NLR before chemotherapy was 3. 02（ ranged from 1. 45 to 5. 34）. According to the standard of NLR ≥ 3. 82,NLR had been elevated in 5 patients（ ≥3.82）. After chemotherapy,the median value of NLR was 2. 81（ ranged from 1. 13 to 4. 98）. The value of NLR in 7 patients had been decreased（〈 3.82） with the decrease rate of 26.93%（ 7/ 26）. The 3 years and 5 years recurrence- free survival rates in patients with high preoperative NLR were 60. 4 % and 53. 6 % respectively,they were significantly lower than those of low NLR patients（ 80. 4%,72. 5%）（ log- rank χ2= 8. 53,P = 0. 021）. The 3 years and 5 years recurrence- free survival rates in patients with high postoperative NLR before chemotherapy were56. 8 % and 50. 3% respectively,they were significantly lower than those of low NLR patients（ 82. 9%,76. 5%）（ log- rank χ2= 9. 25,P =0. 013）. The 3 years and 5 years recurrence- free survival rates in patients with high NLR in 3 months after chemotherapy were 61. 2% and 54.9% respectively,they were significantly lower than those of low NLR patients（ 78. 6%,70. 4%）（ log- rank χ2= 7. 95,P = 0. 028）. Conclusion The dynamic change in levels of NLR can be served as a valuable predictor in patients with colon cancer.