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术前中性粒细胞与淋巴细胞比值对行根治性切除术的肝细胞癌患者预后的影响
Preoperative neutrophil-lymphocyte ratio is an independent prognostic factor for hepatocellular carcinoma after radical resection
文章发布日期:2015年05月08日  来源:  作者:张婷婷,赵向前,刘哲,等  点击次数:1315次  下载次数:557次

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【摘要】:目的评价术前中性粒细胞与淋巴细胞比值(NLR)对经外科根治性切除的肝细胞癌(HCC)患者预后的影响及其预测价值。方法回顾性分析245例2004年1月1日-2009年12月31日在中国人民解放军总医院接受根治性切除术的HCC患者的临床资料。通过Log-rank单因素分析法评估各临床病理特征包括NLR对总生存时间的影响;采用Cox比例风险模型将有意义的变量进一步行多因素分析。结果以NLR值为1.5、2及3作为分界点,将研究对象分为4组,分别为NLR<1.5、1.5≤NLR<2、2≤NLR<3及NLR≥3,各组中位总生存时间分别为39.6、38.3、25.4和19.9个月,差异具有统计学意义(P=0.003)。多因素分析显示术前外周血NLR、AFP、ALT水平、肿瘤结节数量、肿瘤组织最大径以及门静脉癌栓是影响HCC患者预后的独立危险因素(P值均<0.05)。结论术前外周血NLR的水平可以作为外科切除术后HCC患者的新的预后标志物。
【Abstract】:ObjectiveTo evaluate the effect and predictive value of preoperative neutrophil-lymphocyte ratio (NLR) on the prognosis of patients undergoing radical resection for hepatocellular carcinoma (HCC). MethodsThe clinical data of 245 patients who received radical resection for HCC in our hospital from 2004 to 2009 were retrospectively analyzed. The effects of clinicopathological parameters including NLR on overall survival (OS) time were assessed by univariate analysis using the log-rank test. The significant variables were further analyzed by multivariate analysis using the Cox regression model. ResultsUsing NLR=1.5, 2, and 3 as cut-off points, the patients were divided into four groups. The median OS time in groups with NLR<1.5, 1.5≤NLR<2, 2≤NLR<3, and NLR≥3 was 39.6, 38.3, 25.4, and 19.9 months, respectively (P=0.003). Multivariate analysis showed that preoperative NLR, levels of alpha-fetoprotein and alanine aminotransferase in peripheral blood, number of tumor nodules, maximum size of tumor, and portal vein tumor thrombus were independent prognostic factors for HCC (P<0.05). ConclusionPreoperative NLR in peripheral blood is a novel prognostic biomarker for HCC after radical resection.
【关键字】:癌,肝细胞;中性白细胞;淋巴细胞;肝切除术;预后
【Key words】:carcinoma, hepatocellular; neutrophils; lymphocytes; hepatectomy; prognosis
【引证本文】:

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