外周血中性粒细胞与淋巴细胞比值(NLR)与结直肠癌不同期别预后的研究
Study of Perpheral Neutrophil to Lymphocyte Ratio (NLR) in Different Stages Prognosis of Colorectal Cancer

作者: 尹端端 , 杨雁鸿 :秦皇岛市第一医院,河北 秦皇岛; 王真真 , 李倩影 , 冯 博 , 冯 悦 , 王小玉 :承德医学院研究生院,河北 承德;

关键词: 结直肠癌中性粒细胞/淋巴细胞比值(NLR)预后因素总生存期无进展生存期Colorectal Cancer Neutrophil/Lymphocyte Ratio (NLR) Prognostic Factors Overall Survival Progression Free Survival

摘要:
目的:探讨NLR评价结直肠癌不同分期预后的价值,为结直肠癌患者开展个体化治疗、延长生存期提供理论依据。方法:统计符合要求的结直肠癌患者,依据ROC曲线取得NLR = 2.54值为本课题的研究截点,并分为低、高NLR两组,比较两组患者在临床特征及预后生存期的差异。结果:单因素分析证实:低、高NLR组在除年龄外的其他基本特征间差异无统计学意义(P < 0.05);在临床特征(治疗前白细胞计数、TNM分期)方面比较差异有统计学意义(P < 0.05);治疗前低NLR组与高NLR组患者的1、3年生存率、总生存期(OS)、3年无进展生存期(PFS)差异均有统计学意义(P < 0.05)。多因素分析证实:NLR和TNM分期方法分别是结直肠癌的独立危险预后因素。结论:NLR与结直肠癌相关预后因素中的年龄、治疗前白细胞计数、TNM分期相关。

Abstract: Objective: The study investigates NLR to evaluate at different stages prognosis of colorectal cancer, then provides individualized treatment and prolong survival theoretical basis for colorectal cancer patients. Methods: Add up all colorectal cancer patients who meet the requirements, and choose NLR = 2.54 as study intercept according to the ROC curve. All the patients were divided into low NLR and high NLR groups, then clinical features and prognosis of survival of the two groups would be compared. Results: Univariate analysis showed that: There was no significant difference in the basic features besides age between low NLR and high NLR groups (P < 0.05). There was statistically significant difference in clinical features (white blood cell count before treatment, TNM staging) between the two groups (P < 0.05). There were statistically significant differences in 1- and 3-year survival rate, overall survival (OS) and 3-year progression-free survival (PFS) between the two groups (P < 0.05). Multivariate analysis confirmed: NLR and TNM staging were independent risk factors for colorectal cancer prognosis. Conclusion: NLR is correlated with age, the white blood cell count before treatment and TNM staging in prognostic factors of colorectal cancer.

文章引用: 尹端端 , 王真真 , 杨雁鸿 , 李倩影 , 冯 博 , 冯 悦 , 王小玉 (2016) 外周血中性粒细胞与淋巴细胞比值(NLR)与结直肠癌不同期别预后的研究。 亚洲肿瘤科病例研究, 5, 27-38. doi: 10.12677/ACRPO.2016.52003

参考文献

[1] 赵敏. 炎性反应在肿瘤发生发展中的作用[J]. 吉林医学, 2014, 35(7): 1488-1490.

[2] 朴美慈, 金仁顺. 术前NLR PLR与乳腺癌预后的相关性[J]. 中国肿瘤临床, 2015, 42(23): 1128-1131.

[3] 郭智兴, 韦玮, 钟崇, 等. 青年肝癌患者术前中性粒细胞与淋巴细胞比值与预后的相关性[J]. 癌症, 2009, 28(11): 1203-1208.

[4] 金鑫, 冯利, 李富广, 等. 血清中性粒细胞/淋巴细胞比值与胃肠间质瘤患者预后的关系及其临床意义[J]. 中国普外基础与临床杂志, 2013, 20(8): 910-914.

[5] 廖雪芬, 庞芹. 术前中性粒细胞/淋巴细胞比值与宫颈癌患者预后的关系[J]. 医学理论与实践, 2016, 29(4): 433-435.

[6] Mantovani, A. (2009) Cancer Inflaming Metastasis. Nature, 457, 36-37.
http://dx.doi.org/10.1038/457036b

[7] Coussens, L.M. and Werb, Z. (2002) Inflammation and Cancer. Nature, 420, 860-867.
http://dx.doi.org/10.1038/nature01322

[8] Witz, I.P. (2008) Yin-Yang Activities and Vicious Cycles in the Tumor Mi-cro-Environment. Cancer Research, 68, 9- 13.
http://dx.doi.org/10.1158/0008-5472.CAN-07-2917

[9] Li, H.C., Fan, X.L. and Oughton, J. (2007) Tumor Microenvironment: The Role of the Tumor Stroma in Cancer. J Cell Biochem, 101, 805-815.
http://dx.doi.org/10.1002/jcb.21159

[10] 刘天聪. 肿瘤相关中性粒细胞对肿瘤生长的双重作用[J]. 微生物学免疫学进展, 2013, 41(22): 69-72.

[11] Hayden, E.C. (2009) Cutting off Cancer’s Supply Lines (Special Report). Nature, 45, 686-687.
http://dx.doi.org/10.1038/458686b

[12] Sinla, G. (2003) Bacterial Battalions Join War against Cancer. Nature Medicine, 9, 12-29.

[13] 刘德锋, 孟翔凌. 肿瘤相关中性粒细胞的研究进展[J]. 中华临床医师杂志(电子版), 2013, 7(2): 797-798.

[14] Mantovani, A., Allavena, P., Sica, A., et al. (2008) Cancer-Related Inflammation. Nature, 45, 436-444.
http://dx.doi.org/10.1038/nature07205

[15] 武庆, 周海梦, 李旭辉. 浸润性中性粒细胞在促进肿瘤进展中的作用[J]. 生物化学与生物物理进展, 2015, 42(5): 410-418.

[16] 李健, 叶定伟, 姚旭东. 术前血小板/淋巴细胞比值判断上尿路尿路上皮癌临床分期及预后的价值[J]. 中国癌症杂志, 2013, 23(6): 457-461.

[17] Kokawa, K., Mikami, Y., Sakata, H., et al. (2009) Clinical Outcome and Prognostic Factors in Borderline Tumors of the Ovary. Results from 17 Years’ Experience in the Kinki District of Japan (1990-2006). European Journal of Gynaecological Oncology, 30, 155-161.

[18] Poncelet, C., Fauvet, R., Yazbeck, C., Coutant, C. and Darai, E. (2010) Impact of Serum Tumor Marker Determination on the Management of Women with Borderline Ovarian Tumors: Multivariate Analysis of a French Multicentre Study. European Journal of Surgical Oncology, 36, 1066-1072.
http://dx.doi.org/10.1016/j.ejso.2010.07.004

[19] Kelly, P.J., Archbold, P., Price, J.H., Cardwell, C. and McCluggage, W.G. (2010) Serum CA19.9 Levels Are Commonly Elevated in Primary Ovarian Mucinous Tumours but Cannot Be Used to Predict the Histological Subtype. Journal of Clinical Pathology, 63, 169-173.
http://dx.doi.org/10.1136/jcp.2009.072355

[20] 胡秦妮, 张玉琴, 邓芝云. 中性粒细胞与淋巴细胞比值预测急性胰腺炎严重程度的意义[J]. 国际检验医学杂志, 2013, 34(23): 3119-3121.

[21] Rao, H.L., Chen, J.W., Li, M., et al. (2012) Increased Intratumoral Neutrophil in Colorectal Carcinomas Correlates Closely with Malignant Phenotype and Predicts Patients’ Adverse Prognosis. PLoS ONE, 7, e30806.
http://dx.doi.org/10.1371/journal.pone.0030806

[22] 王智, 马晋平, 林建伟. 术前中性粒细胞与淋巴细胞比值与结直肠癌患者预后的关系[J]. 消化肿瘤杂志, 2011, 4(3): 246-250.

[23] 李芳飘. 外周血中性/淋巴细胞比例对直肠癌患者手术预后的预测价值[J]. 重庆医学, 2014, 43(8): 925-929.

[24] Cetin, B., Kaplan, M.A., Berk, V., et al. (2012) Prognostic Factors for Overall Survival in Patients with Metastatic Colorectal Carcinoma Treated with Vascular Endothelial Growth Factor-Targeting Agents. Asian Pacific Journal of Cancer Prevention, 13, 1059-1063.
http://dx.doi.org/10.7314/APJCP.2012.13.3.1059

[25] Kubo, T., Ono, S., Ueno, H., Shinto, E., Yamamoto, J. and Hase, K. (2014) Impact of the Perioperative Neutrophil-to- Lymphocyte Ratio on the Long-Term Survival Following an Elective Resection of Colorectal Carcinoma. International Journal of Colorectal Disease, 29, 109-112.
http://dx.doi.org/10.1007/s00384-014-1964-1

[26] Malietzis, G., Giacometti, M., Kennedy, R.H., Athanasiou, T., Aziz, O. and Jenkins, J.T. (2014) The Emerging Role of Neutrophil to Lymphocyte Ratio in Determining Colorectal Cancer Treatment Outcomes: A Systematic Review and Meta-Analysis. Annals of Surgical Oncology, 5, 245-251.

[27] Yoshioka, S., Kubo, M., Yanagisawa, K., et al. (2013) Clinical Significance of Neutrophil to Lymphocyte Ratio in Colorectal Cancer Patients Receiving Adjuvant Chemotherapy Combined with Polysaccharide-K. Gan to Kagaku Ryoho. Cancer & Chemotherapy, 40, 2086-2088.

[28] Shibutani, M., Maeda, K., Nagahara, H., et al. (2013) Significance of Preoperative Neutrophil-to-Lymphocyte Ratio as a Predictor of Prognosis in Patients with Stage IV Colorectal Cancer. Gan to Kagaku Ryoho. Cancer & Chemotherapy, 40, 1603-1605.

[29] Absenger, G., Szkandera, J. and Stotz, M. (2013) Preoperative Neutrophil-to-Lymphocyte Ratio Predicts Clinical Outcome in Patients with Stage II and III Colon Cancer. Anticancer Research, 33, 4591-4594.

[30] Absenger, G., Szkandera, J., Pichler, M., et al. (2013) A Derived Neutrophil to Lymphocyte Ratio Predicts Clinical Outcome in Stage II and III Colon Cancer Patients. British Journal of Cancer, 109, 395-400.
http://dx.doi.org/10.1038/bjc.2013.346

[31] Proctor, M.J., McMillan, D.C., Morrison, D.S., Fletcher, C.D., Horgan, P.G. and Clarke, S.J. (2012) A Derived Neutrophil to Lymphocyte Ratio Predicts Survival in Patients with Cancer. British Journal of Cancer, 107, 695-709.
http://dx.doi.org/10.1038/bjc.2012.292

分享
Top