CAJ | 학술논문

目的：探讨原发性肝癌（PHC）患者术前中性粒细胞/淋巴细胞比值（NLR）对预后的影响。方法：回顾性分析96例行经导管肝动脉栓塞化疗（TACE）术的 PHC 患者临床病理资料。根据术前 NLR 值，分为低NLR 组（NLR ＜2.5）和高 NLR 组（NLR≥2.5），分析两组患者总生存时间与无进展生存时间；并对其影响预后的危险因素行单因素与多因素分析。结果：全组介入术后，中位总生存时间21.1个月；其中术前高 NLR 组中位总生存时间16.0个月；术前低 NLR 组中位总生存时间23.3个月；两组中位生存时间差异有统计学意义（P=0.002）。全组患者中位无进展生存时间13.8个月，其中高 NLR 组中位无进展生存时间9.6个月，低 NLR组中位无进展生存时间17.6个月，两组中位无进展生存时间差异有统计学意义（P =0.011）。单因素分析显示：肝功能 Child 分级、BCLC 分期、AFP、假包膜形成、血供、TACE 次数、NLR≥2.5是影响 PHC 患者 TACE 术后总生存时间的危险因素（P ＜0.05）。肝功能 Child 分级、BCLC 分期、假包膜形成、血供、NLR≥2.5是影响PHC 患者 TACE 术后无进展生存时间的危险因素（P ＜0.05）；多因素分析显示，肝功能 Child 分级、BCLC 分期、NLR≥2.5是影响 PHC 患者 TACE 术后生存的独立预后因素（P ＜0.05）。BCLC 分期、NLR≥2.5是影响 PHC患者 TACE 术后无进展生存时间的独立预后因素（P ＜0.05）。结论：术前外周血 NLR 可作为 PHC 患者行 TA-CE 的预后指标，NLR 高者预后差。
목적：탐토원발성간암（PHC）환자술전중성립세포/림파세포비치（NLR）대예후적영향。방법：회고성분석96례행경도관간동맥전새화료（TACE）술적 PHC 환자림상병리자료。근거술전 NLR 치，분위저NLR 조（NLR ＜2.5）화고 NLR 조（NLR≥2.5），분석량조환자총생존시간여무진전생존시간；병대기영향예후적위험인소행단인소여다인소분석。결과：전조개입술후，중위총생존시간21.1개월；기중술전고 NLR 조중위총생존시간16.0개월；술전저 NLR 조중위총생존시간23.3개월；량조중위생존시간차이유통계학의의（P=0.002）。전조환자중위무진전생존시간13.8개월，기중고 NLR 조중위무진전생존시간9.6개월，저 NLR조중위무진전생존시간17.6개월，량조중위무진전생존시간차이유통계학의의（P =0.011）。단인소분석현시：간공능 Child 분급、BCLC 분기、AFP、가포막형성、혈공、TACE 차수、NLR≥2.5시영향 PHC 환자 TACE 술후총생존시간적위험인소（P ＜0.05）。간공능 Child 분급、BCLC 분기、가포막형성、혈공、NLR≥2.5시영향PHC 환자 TACE 술후무진전생존시간적위험인소（P ＜0.05）；다인소분석현시，간공능 Child 분급、BCLC 분기、NLR≥2.5시영향 PHC 환자 TACE 술후생존적독립예후인소（P ＜0.05）。BCLC 분기、NLR≥2.5시영향 PHC환자 TACE 술후무진전생존시간적독립예후인소（P ＜0.05）。결론：술전외주혈 NLR 가작위 PHC 환자행 TA-CE 적예후지표，NLR 고자예후차。
Objective:To investigate the impact of the preoperative peripheral blood neutrophil - to - lymphocyte ratio(NLR)on postoperative prognosis of patients with primary hepatic cancer(PHC). Methods:Clinicopathologic data of 96 PHC patients undergoing transcatheter arterial chemoembolization(TACE)were analyzed retrospectively. Based on the preoperative neutrophil - to - lymphocyte ratio(NLR),the patients were divided into low NLR group (NLR < 2. 5)and high NLR(NLR≥2. 5)group. The overall survival time and progress - free survival time of the two groups were analyzed,and risk factors that would influence the prognosis of these patients were determined by uni-variate and multivariate analyses. Results:The median overall survival time for the entire group was 21. 1 months, which for high NLR group and low NLR group was 16. 0 and 23. 3 respectively. The difference in the overall survival between the two groups had statistical significance(P = 0. 002). The median progress free survival time for the entire group was 13. 8 months,which for high NLR group and low NLR group was 9. 6 and 17. 6,and there was statistically significant difference in the progression - free survival time between the two groups(P = 0. 011). Univariate analysis showed that liver function Child classification,BCLC staging,AFP,formation of psuedocapsule,blood supply,frequen-cy of TACE and NLR≥2. 5 were the risk factors for the postoperative overall survival time of PHC patients undergoing TACE(P < 0. 05),and liver function Child classification,BCLC staging,formation of psuedocapsule,blood supply and NLR≥2. 5 were the risk factors for the postoperative progress - free time of PHC patients undergoing TACE(P <0. 05). Multivariate analysis revealed that liver function Child classification,BCLC staging and NLR≥2. 5 were the independent prognostic factors for the survival of PHC patients undergoing TACE(all P < 0. 05),and BCLC staging and NLR≥2. 5 were the independent prognostic factors for postoperative progress - free time of PHC patients under-going TACE(P < 0. 05). Conclusion:Preoperative peripheral blood NLR can be used as a prognostic predictor of PHC patients undergoing TACE,and those with high NLR face a poor prognosis.