CAJ | 학술논문

目的：评价术前NLR（中性／淋巴细胞）、D－NLR（间接中性／淋巴细胞）、PLR（血小板／淋巴细胞）和LMR（淋巴细胞／单核细胞）比值对结直肠癌患者预后的影响和预测价值。方法：回顾分析南京第一医院205例经过手术治疗的结直肠癌患者的临床资料及回访资料，采用受试者工作特征曲线区分高比值组和低比值组，并采用单因素和COX 回归模型分析两组患者的NLR、D－NLR、PLR 和LMR 及其他临床病理因素与5年无复发生存率的关系。结果：根据ROC 曲线，LMR 的曲线下面积小于0．5，所以不能用作结直肠癌患者的预后诊断的指标；当NLR 的截点为3．12时，对术后复发和预后的预测价值最高，同时在单因素分析中显示，NLR、D－NLR 和PLR 都对患者的无复发生存率有影响（P＜0．05），多因素的回归分析中，NLR≥3．12和肿瘤分期是结直肠癌复发的独立危险因素。结论：术前NLR≥3．12是影响结直肠癌患者术后复发的独立危险因素，对患者的预后有预测价值。
목적：평개술전NLR（중성／림파세포）、D－NLR（간접중성／림파세포）、PLR（혈소판／림파세포）화LMR（림파세포／단핵세포）비치대결직장암환자예후적영향화예측개치。방법：회고분석남경제일의원205례경과수술치료적결직장암환자적림상자료급회방자료，채용수시자공작특정곡선구분고비치조화저비치조，병채용단인소화COX 회귀모형분석량조환자적NLR、D－NLR、PLR 화LMR 급기타림상병리인소여5년무복발생존솔적관계。결과：근거ROC 곡선，LMR 적곡선하면적소우0．5，소이불능용작결직장암환자적예후진단적지표；당NLR 적절점위3．12시，대술후복발화예후적예측개치최고，동시재단인소분석중현시，NLR、D－NLR 화PLR 도대환자적무복발생존솔유영향（P＜0．05），다인소적회귀분석중，NLR≥3．12화종류분기시결직장암복발적독립위험인소。결론：술전NLR≥3．12시영향결직장암환자술후복발적독립위험인소，대환자적예후유예측개치。
Objective:To evaluate the impact and predictive value of neutrophil-to-lymphocyte ratio( NLR) ,derived neutrophil-to-lymphocyte ratio( d-NLR) ,platelet-to-lymphocyte ratio( PLR) and lymphocyte-to-monocyte ratio( LMR) on the prognosis of patients with colorectal cancer with curative resection.Methods: Retrospective analysis of 205 cases of clinical data and returning data after patients with colorectal cancer surgery,ROC curve was applied to determine thresholds for four biomarkers and their prognostic values were assessed using Kaplan-Meier curve,univariate and multivariate COX regression models of patients with NLR,D-NLR,PLR and LMR and other clinicopathological factors and the relationship between the 5-year recurrent-free survival( RFS).Results:According to the ROC curve,LMR could not be used as a potential diagnostic biomarker for subsequently analysis,for its AUC was less than 0.50, The optimal cut-off values were 3.12 with the highest specificity and sensitivity ( 75% and 73.1%) for NLR, while in the univariate analysis show,NLR,D-NLR and PLR were all risk factors of poor recurrence-free survival ( P<0.05 ) , the multivariate regression analysis,NLR≥3.12 and colorectal cancer staging were independent risk factors of prognosis of colorectal cancer.Conclusion:NLR≥3.12 can provide improved accuracy for predicting clinical outcomes in surgical CRC patients under surgery resection.