中性粒细胞淋巴细胞比值与两医院7 187例结直肠癌肝转移临床资料回顾分析

目的结直肠癌(colorectal cancer,CRC)已经成为严重危害我国人民健康的恶性肿瘤之一,CRC患者死亡大多是因为转移所致,而肝脏为CRC最易发生转移的器官,因此,是否发生肝转移对于CRC患者的预后意义重大。有关炎症指标与CRC的研究表明,中性粒细胞淋巴细胞比值(neutrophil-to-lymphocyte ratio,NLR)等炎症指标与CRC以及结直肠癌肝转移(colorectal liver metastases,CRLM)患者的预后密切相关,但目前尚无研究报道NLR与CRLM相关,本研究的目的是通过大宗临床病例回顾性横断面研究探讨NLR和结直肠癌同时性肝转移(synchronous colorectal liver metastases,synCRLM)的相关性。方法回顾性分析连续7 187例(4 033例为青岛大学附属医院患者,3 154例为郑州大学第一附属医院患者)初诊为CRC患者的临床资料;比较有和无同时性肝转移(synCRLM^+ vs synCRLM^-)患者间NLR值的差异;以单因素和多因素二元Logistic回归分析发生synCRLM的关联因素。结果 synCRLM^+组NLR值高于synCRLM^-组,差异有统计学意义,Z=-8.543,P<0.001。单因素Logistic回归分析显示,NLR与synCRLM显著相关(95%CI为1.006~1.038,OR=1.022,P=0.008),但多因素Logistic回归分析提示NLR不是synCRLM的独立危险因素(95%CI为0.650~2.010,OR=1.143,P=0.643)。结论 NLR与synCRLM具有一定关联,然而升高的NLR并不是synCRLM的独立危险因素。

Retrospective analysis of neutrophil-to-lymphocyte ratio and 7187 patients with colorectal liver metastases in two hospital

OBJECTIVE Colorectal cancer(CRC)has become one of the malignant tumor that seriously endanger the health of the people in China.Most of the death of CRC patients is caused by metastasis,and the liver is the mostly frequent cite of metastasis in CRC.Therefore,whether there is liver metastasis is of great significance for the prognosis of CRC patients.Recently,many studies on inflammatory markers and CRC have shown that inflammatory markers such as the neutrophil-to-lymphocyte ratio(NLR)are associated with outcomes of CRC and CRLM patients,but there is no research report on the relationship between NLR and CRLM.The purpose of this study was to explore the correlation between NLR and synchronous coloretal liver metastasis(synCRLM)through a retrospective cross-sectional study of a large number of clinical cases.METHODS The clinical data of 7187 consecutive patients(4033 patients in Affiliated Hospital of Qingdao University and 3154 patients in the First Affiliated Hospital of Zhengzhou University)who were initially diagnosed as CRC were analyzed retrospectively.The difference of NLR between patients in synCRLM^+group and synCRLM^-group was compared;related factors of synCRLM were studied by univariate and multivariate logistic regression analysis.RESULTS The NLR of synCRLM^+group was significantly higher than that of synCRLM^-group(z=-8.543,P<0.001).Univariate logistic regression analysis showed that NLR was significantly correlated with synCRLM(P=0.008,OR=1.022,95%CI:1.006-1.038),but multivariate logistic regression analysis suggested that NLR was not an independent risk factor of synCRLM(P=0.643,OR=1.143,95%CI:0.650-2.010).CONCLUSION NLR is related to synCRLM,but it can not be proved as an independent risk factor for synCRLM.