术前血小板与中性粒细胞比对可切除同时性结直肠癌肝转移患者的预后价值

肝癌电子杂志 ›› 2024, Vol. 11 ›› Issue (2): 66-71.

术前血小板与中性粒细胞比对可切除同时性结直肠癌肝转移患者的预后价值

张吉欣¹, 武亮², 武雪亮^1,3,*, 王立坤⁴, 马洪庆⁵, 韩磊¹

1.河北北方学院附属第一医院普通外科,河北张家口 075000;
2.河北北方学院附属第一医院手术室,河北张家口 075000;
3.河北北方学院附属第一医院肿瘤研究所,河北张家口 075000;
4.河北北方学院附属第一医院超声医学科,河北张家口 075000;
5.河北医科大学第四医院外二科,河北石家庄 050000

收稿日期:2023-04-01 出版日期:2024-06-30 发布日期:2024-09-05
通讯作者: ^*武雪亮,E-mail: wxlwlk@163.com

The prognostic value of preoperative platelet to neutrophil ratio in colorectal cancer patients with resectable synchronous liver metastases

Zhang Jixin¹, Wu Liang², Wu Xueliang^1,3,*, Wang Likun⁴, Ma Hongqing⁵, Han Lei¹

1. Department of General Surgery, First Affiliated Hospital of Hebei North University, Zhangjiakou 075000,Hebei, China;
2. Operating Room, First Affiliated Hospital of Hebei North University, Zhangjiakou 075000,Hebei, China;
3. Institute of Oncology, First Affiliated Hospital of Hebei North University, Zhangjiakou 075000,Hebei, China;
4. Department of Ultrasound, First Affiliated Hospital of Hebei North University, Zhangjiakou 075000,Hebei, China;
5. The Second Department of General Surgery, Fourth Hospital of Hebei Medical University, Shijiazhuang 050000, Hebei, China

Received:2023-04-01 Online:2024-06-30 Published:2024-09-05
Contact: ^*Wu Xueliang, E-mail: wxlwlk@163.com

摘要/Abstract

摘要： 目的：探讨术前外周血血小板与淋巴细胞比（PLR）对同时性结直肠癌肝转移患者的预后价值。
方法：回顾性收集2010—2017年于河北北方学院第一附属医院行同期肝切除的74例结直肠癌肝转移患者的临床病理资料。利用X-tile软件计算PLR预后的最佳界值,并将患者分为低PLR组31例,高PLR组43例。探讨两组患者的一般临床病理资料及预后差异。
结果：PLR预后的最佳界值为188,PLR>188为高PLR组,PLR<188为低PLR组。高PLR组相比于低PLR组患者的肿瘤分期较晚、淋巴结转移率较高且肝转移数目更多（均P<0.05）。低PLR组和高PLR组患者的中位生存时间分别为33个月和11个月（P=0.001)。Cox模型多因素分析显示pT分期（HR=2.199,95%CI为1.156~4.182,P=0.016）、癌胚抗原≥3.4 ng/ml（HR=1.834,95%CI为1.079~3.117,P=0.025）及PLR≥188（HR=1.885,95%CI为1.022~3.477,P=0.042）是同时性结直肠癌肝转移患者预后的独立危险因素。根据生存分析结果构建了预后预测模型,有效性验证曲线和受试者操作特征曲线均示模型拟合度和准确度较好。
结论：术前PLR与同时性结直肠癌肝转移患者的不良预后密切相关,术前PLR水平≥188的患者预后更差。基于PLR、T分期及癌胚抗原构建的生存预测模型的准确度较高,可用于指导临床。

关键词: 结直肠癌, 肝转移, 血小板与中性粒细胞比, 预后

Abstract: Objective: To investigate the prognostic value of preoperative serum platelet to lymphocyte ratios (PLR) in colorectal cancer patients with synchronous liver metastases.
Methods: The 74 patients clinicopathological data of in colorectal cancer patients with synchronous liver metastases who underwent liver resection in First Affiliated Hospital of Hebei North University were collected retrospectively. The X-tile software was used to calculate the best cut-off value of PLR toward prognosis, and the patients were divided into low PLR group (n=31) and high PLR group (n=43) according to the aforementioned cut-off value. Differences in general clinicopathological data and prognosis of the two group patients were investigated.
Results: The best cut-off for PLR prognosis was 188, PLR≥188 was the high PLR group and PLR<188 was the low PLR group. Compared with patients in the low PLR group, the tumor stage of the high PLR group was later, the lymph node metastasis rate was higher, and the number of liver metastases was more (all P<0.05). The median survival time of patients in the high PLR group and the low PLR group were 33 months and 11 months (P=0.001), respectively. The Cox model multivariate analysis showed that pT staging (HR=2.199, 95%CI: 1.156-4.182, P=0.016), carcinoembryonic antigen ≥3.4 ng/ml (HR=1.834, 95%CI: 1.079-3.117, P=0.025), and PLR≥188 (HR=1.885, 95%CI: 1.022-3.477, P=0.042) were independent risk factors for the colorectal cancer patients with synchronous liver metastases. The prognostic prediction model was constructed according to the results of the survival analysis, and the validity curve and the receiver operation characteristic curve showed good model fit and accuracy.
Conclusions: Preoperative PLR is closely related to the poor prognosis of colorectal cancer patients with synchronous liver metastases. Patients with preoperative PLR≥188 have a worse prognosis. The survival prediction models is constructed based on PLR, T stage and carcinoembryonic antigen have high accuracy and can be used to guide clinical practice.

Key words: Colorectal cancer, Liver metastasis, Platelet-neutrophil ratio, Prognosis

张吉欣, 武亮, 武雪亮, 王立坤, 马洪庆, 韩磊. 术前血小板与中性粒细胞比对可切除同时性结直肠癌肝转移患者的预后价值[J]. 肝癌电子杂志, 2024, 11(2): 66-71.

Zhang Jixin, Wu Liang, Wu Xueliang, Wang Likun, Ma Hongqing, Han Lei. The prognostic value of preoperative platelet to neutrophil ratio in colorectal cancer patients with resectable synchronous liver metastases[J]. Electronic Journal of Liver Tumor, 2024, 11(2): 66-71.

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