术前中性粒细胞/淋巴细胞比值及临床病理特征与胰腺癌根治术预后的相关性分析

目的:探讨术前中性粒细胞/淋巴细胞比值（NLR）及临床病理特征对胰腺癌根治术的预后价值。方法:回顾性分析2016年1月-2017年12月于天津市肿瘤医院行胰腺癌根治术的122例患者的临床病理资料和随访资料（随访截止日期为2019年7月15日）。收集患者术前1周的血清学结果,统计患者中性粒细胞数及单核细胞数,通过ROC曲线选出灵敏度及特异度最大的值为NLR的截止值,并将患者分为低NLR组和高NLR组,运用卡方检验比较两组间的差异性。通过Cox 比例风险回归模型分析影响患者生存预后的因素。结果:单因素分析结果显示:年龄、饮酒、神经侵犯、肿瘤大小、淋巴结转移、TNM分期、NLR与胰腺癌根治术后生存有关;多因素结果显示:年龄、饮酒、神经侵犯、肿瘤大小、NLR是胰腺癌预后的独立影响因素。结论:年龄大于61岁、有饮酒史、有神经侵犯、肿瘤大于4 cm、有局部淋巴结转移、NLR＞2.0的患者预后较差。

Correlation between preoperative neutrophil/lymphocyte ratio and clinicopathological features and prognosis of pancreatic cancer radical resection

Objective: To investigate the prognostic value of preoperative neutrophil/lymphocyte ratio(NLR) and clinicopathological features for radical resection of pancreatic cancer. Methods:The clinical and pathological data and follow-up data of 122 patients who underwent radical resection of pancreatic cancer in Tianjin Cancer Hospital from January 2016 to December 2017 were retrospectively analyzed (the follow-up deadline was July 15, 2019). The serological results of patients 1 week before surgery were collected. The number of neutrophils and monocytes in the patients were counted. The maximum sensitivity and specificity were selected by the ROC curve as the cutoff value of NLR, and the patients were divided into two groups: the low NLR group and the high NLR group. The differences between the two groups were compared by the chi-square test. Factors affecting patient survival prognosis were analyzed by Cox proportional hazards regression model. Results:Univariate analysis showed that age, alcohol consumption, neurological invasion, tumor size, lymph node metastasis, TNM staging, and NLR were associated with survival after radical resection of pancreatic cancer. Multivariate results showed that age, alcohol consumption, neurological invasion, tumor size, and NLR were independent factors influencing pancreatic cancer prognosis. Conclusion:Patients older than 61 years, with a history of drinking, neurological invasion, tumors greater than 4 cm, local lymph node metastasis and NLR＞2.0 have a poor prognosis.