新医学
新醫學
신의학
New Medicine
2015年
10期
685-689
,共5页
结直肠癌%外周血小板与淋巴细胞比值%列线图
結直腸癌%外週血小闆與淋巴細胞比值%列線圖
결직장암%외주혈소판여림파세포비치%렬선도
Colorectal cancer%Platelet-lymphocyte ratio%Nomogram
目的：探讨术前外周血小板与淋巴细胞比值（PLR）判断结直肠癌术后患者临床预后的价值。方法收集822例结直肠癌患者的术前血常规结果，并对上述纳入患者进行为期5年的随访；用 Kaplan-Meier 曲线和多因素 Cox 回归评估术前 PLR 对其临床预后的影响，同时评价其临床预后预测列线图的预测价值。结果高 PLR 与 TNM-Ⅲ期、低／未分化、肿瘤浸润深度（T3／T4）和淋巴结转移（N1／N2）相关。Kaplan-Meier 曲线结果表明术前 PLR 与术后结直肠癌患者的无复发生存期（RFS）、总生存期（OS）相关（P 均＜0.001），高 PLR 是判断结直肠癌术后患者临床不良预后（RFS：P ＜0.001，HR ＝2.61，95％CI ＝1.69～4.88；OS：P ＜0.001，HR ＝2.79，95％CI ＝1.63～4.28）的独立预测因子；以 PLR 为基础构建的复发预测列线图和死亡预测列线图的 C-index 分别为0.849和0.821，未含 PLR 因子构建的复发和死亡列线图的 C-index 分别0.792和0.775。结论术前高 PLR 与结直肠癌患者的术后 RFS、OS 呈负相关，术前 PLR 是结直肠癌患者术后 RFS、OS 的独立预后因子，由其构建的复发和死亡预测列线图可明显提高术后患者临床预后的预测效能。
目的：探討術前外週血小闆與淋巴細胞比值（PLR）判斷結直腸癌術後患者臨床預後的價值。方法收集822例結直腸癌患者的術前血常規結果，併對上述納入患者進行為期5年的隨訪；用 Kaplan-Meier 麯線和多因素 Cox 迴歸評估術前 PLR 對其臨床預後的影響，同時評價其臨床預後預測列線圖的預測價值。結果高 PLR 與 TNM-Ⅲ期、低／未分化、腫瘤浸潤深度（T3／T4）和淋巴結轉移（N1／N2）相關。Kaplan-Meier 麯線結果錶明術前 PLR 與術後結直腸癌患者的無複髮生存期（RFS）、總生存期（OS）相關（P 均＜0.001），高 PLR 是判斷結直腸癌術後患者臨床不良預後（RFS：P ＜0.001，HR ＝2.61，95％CI ＝1.69～4.88；OS：P ＜0.001，HR ＝2.79，95％CI ＝1.63～4.28）的獨立預測因子；以 PLR 為基礎構建的複髮預測列線圖和死亡預測列線圖的 C-index 分彆為0.849和0.821，未含 PLR 因子構建的複髮和死亡列線圖的 C-index 分彆0.792和0.775。結論術前高 PLR 與結直腸癌患者的術後 RFS、OS 呈負相關，術前 PLR 是結直腸癌患者術後 RFS、OS 的獨立預後因子，由其構建的複髮和死亡預測列線圖可明顯提高術後患者臨床預後的預測效能。
목적：탐토술전외주혈소판여림파세포비치（PLR）판단결직장암술후환자림상예후적개치。방법수집822례결직장암환자적술전혈상규결과，병대상술납입환자진행위기5년적수방；용 Kaplan-Meier 곡선화다인소 Cox 회귀평고술전 PLR 대기림상예후적영향，동시평개기림상예후예측렬선도적예측개치。결과고 PLR 여 TNM-Ⅲ기、저／미분화、종류침윤심도（T3／T4）화림파결전이（N1／N2）상관。Kaplan-Meier 곡선결과표명술전 PLR 여술후결직장암환자적무복발생존기（RFS）、총생존기（OS）상관（P 균＜0.001），고 PLR 시판단결직장암술후환자림상불량예후（RFS：P ＜0.001，HR ＝2.61，95％CI ＝1.69～4.88；OS：P ＜0.001，HR ＝2.79，95％CI ＝1.63～4.28）적독립예측인자；이 PLR 위기출구건적복발예측렬선도화사망예측렬선도적 C-index 분별위0.849화0.821，미함 PLR 인자구건적복발화사망렬선도적 C-index 분별0.792화0.775。결론술전고 PLR 여결직장암환자적술후 RFS、OS 정부상관，술전 PLR 시결직장암환자술후 RFS、OS 적독립예후인자，유기구건적복발화사망예측렬선도가명현제고술후환자림상예후적예측효능。
Objective To investigate the clinical significance of preoperative platelet-lymphocyte ra-tio (PLR)in predicting the clinical prognosis of colorectal cancer (CRC)patients after surgery.Methods Preoperative blood routine test results were collected from 822 CRC cases.All enrolled patients were subject to 5-year follow-up.Kaplan-Meier curve and multiple Cox regression were utilized to evaluate the influence of pre-operative platelet-lymphocyte ratio (PLR)on clinical outcomes of CRC patients and the value of predictive no-mograms based on PLR was also analyzed.Results High PLR was associated with TNM-Ⅲ,low/non-differ-entiation,depth of tumor invasion (T3 /T4)and lymph node metastasis (N1 /N2).Preoperative PLR was sig-nificantly associated with recurrence-free survival (RFS)and overall survival (OS)(both P <0.001 ).High preoperative PLR was an independent prognostic factor for poor RFS (P <0.001 ,HR =2.52,95%CI =1 .69-4.88)and OS (P <0.001 ,HR =2.79,95%CI =1 .63-4.28).The C-indexes of RFS and OS predictive no-mograms based on PLR were 0.849 and 0.821 ,and 0.792 and 0.775 for the C-indexes without PLR.Conclu-sions High preoperative PLR is negatively correlated with RFS and OS in CRC patients,and it serves as an independent prognostic factor for clinical prognosis.PLR-based nomogram could significantly improve the accu-racy in predicting the clinical prognosis in CRC individuals.
