中性粒细胞与淋巴细胞比值及血小板与淋巴细胞比值变化在直肠癌新辅助治疗中的意义

目的探讨新辅助治疗前后中性粒细胞与淋巴细胞比值(NLR)及血小板与淋巴细胞比值(PLR)变化在直肠癌新辅助治疗中的意义。方法回顾性分析2013年11月至2015年1月山西省肿瘤医院收治的86例接受新辅助治疗的直肠癌患者资料,分析新辅助治疗前后NLR、PLR变化与患者临床病理特征及疗效的关系。结果86例患者治疗后NLR、PLR升高均为43例。直肠癌患者新辅助治疗前后的NLR及PLR变化与患者年龄、性别、TNM分期、淋巴结转移及癌结节数量、肿瘤长径均无关(均P>0.05),肿瘤与肛门距离<6 cm者治疗后NLR、PLR升高者比例均高于≥6 cm者60.00%(30/50)比36.11%(13/36),χ^2=4.778,P=0.029;64.00%(32/50)比30.56%(11/36),χ^2=9.364,P=0.002];体质量指数≥28 kg/m2者治疗后NLR、PLR升高者比例均高于<28 kg/m2者81.82%(9/11)比45.33%(34/75),χ^2=5.108,P=0.024;90.91%(10/11)比44.00%(33/75),χ^2=8.444,P=0.004]。治疗后NLR降低组患者的缓解率高于NLR升高组72.09%(31/43)比51.16%(31/43),χ^2=3.983,P=0.046],而治疗前后PLR变化与患者新辅助治疗效果无关(P>0.05)。结论直肠癌患者新辅助治疗前后NLR变化与其疗效相关。

Significance of changes of neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio in neoadjuvant therapy for rectal cancer

Objective To investigate the significance of changes of neutrophil-to-lymphocyte ratio(NLR)and platelet-to-lymphocyte ratio(PLR)in neoadjuvant therapy for rectal cancer.Methods The data of 86 patients with rectal cancer who received neoadjuvant therapy from November 2013 to January 2015 in Shanxi Provincial Cancer Hospital were retrospectively analyzed,and the correlations of NLR and PLR changes with the patients'clinicopathological characteristics and therapeutic effects were also analyzed.Results There were 43 cases of increased NLR and 43 cases of increased PLR after treatment.NLR and PLR changes before and after neoadjuvant therapy in patients with rectal cancer were not associated with age,gender,TNM stage,lymph node metastasis,number of cancer nodules,and tumor diameter(all P>0.05).The increasing proportion of NLR and PLR after treatment in patients with the distance from the tumor to anus<6 cm was higher than that in those with the distance≥6 cm60.00%(30/50)vs.36.11%(13/36),χ^2=4.778,P=0.029;64.00%(32/50)vs.30.56%(11/36),χ^2=9.364,P=0.002].The increasing proportion of NLR and PLR after treatment in patients with the body mass index(BMI)≥28 kg/m2 was higher than that in those with BMI<28 kg/m281.82%(9/11)vs.45.33%(34/75),χ^2=5.108,P=0.024;90.91%(10/11)vs.44.00%(33/75),χ^2=8.444,P=0.004].The remission rate of patients in NLR reduction group after treatment was higher than that in NLR increase group72.09%(31/43)vs.51.16%(31/43),χ^2=3.983,P=0.046].PLR changes were not associated with the therapeutic effects of neoadjuvant therapy before and after treatment(P>0.05).Conclusion NLR changes are associated with therapeutic efficacy before and after neoadjuvant therapy for patients with rectal cancer.