摘要
目的探讨中性粒细胞-淋巴细胞比值(NLR)对胆管结石相关的肝内胆管癌(ICC)患者术后总体生存率的预测价值。方法回顾性分析2009年1月至2017年10月温州医科大学附属第二医院肝胆外科收治的77例胆管结石相关的ICC患者临床资料。将患者分为高NLR组(NLR>3,n=35)和低NLR组(NLR≤3,n=42),比较两组间临床病理因素,术后总生存时间和1年生存率的差异,通过Cox模型进行单因素、多因素分析,明确影响患者预后的独立危险因素。结果高NLR组中位生存时间为8个月,低NLR组中位生存时间为17个月,Kaplan-Meier分析显示,低NLR组的术后总生存时间长于高NLR组(P<0.05),高NLR组与低NLR组1年生存率分别为42.9%和66.7%,差异具有统计学意义(P<0.05)。多因素分析显示,NLR>3(HR 2.15,95%CI 1.23~3.73,P=0.007)、淋巴结转移(HR 2.04,95%CI 1.10~3.76,P=0.023)、血管侵犯(HR 2.10,95%CI 1.10~4.00,P=0.024)为胆管结石相关的ICC患者预后的独立危险因素。结论NLR>3可以作为胆管结石相关的肝内胆管癌患者不良预后的评价指标之一。
Objective To explore the value of neutrophil-lymphocyte ratio(NLR)in predicting postoperative survival in patients with hepatolithiasis-associated intrahepatic cholangiocarcinoma(ICC).Methods The clinical data of 77 patients with hepatolithiasis-associated icc admitted to the Second Affiliated Hospital of Wenzhou Medical University from Jan.2009 to Oct.2017 were retrospectively analyzed.Patients were divided into high NLR group(NLR>3,n=35)and low NLR group(NLR≤3,n=42).The clinicopathological factors,the overall survival time and 1-year survival rate were compared between the two groups.Univariate and multivariate Cox regression models were applied to identify independent prognostic factors associated with survival.Results The median survival time was 8 months in high NLR group and 17 months in low NLR group.Kaplan-Meier analysis showed that the overall survival time of low NLR group was higher than that of high NLR group(P<0.05).The 1-year survival rate was 66.7%in the low NLR group and 42.9%in the high NLR group,and the difference was statistically significant(P<0.05).Multivariate analysis showed that NLR>3(HR 2.15,95%CI 1.23~3.73,P=0.007),lymph node metastasis(HR 2.04,95%CI 1.10~3.76,P=0.023)and vascular invasion(HR 2.10,95%CI 1.10~4.00,P=0.024)were independent risk factors for prognosis.Conclusion NLR>3 can be used as one of the poor prognosis indicators in patients with hepatolithiasis-associated ICC.
作者
周功挺
洪重
王兆洪
徐鲁白
王继生
周斌
张启瑜
廖毅
ZHOU Gong-ting;HONG Zhong;WANG Zhao-hong;XU Lu-bai;WANG Ji-sheng;ZHOU Bin;ZHANG Qi-yu;LIAO Yi(Department of Hepatobiliary Surgery,the Second Affiliated Hospital of Wenzhou Medical University,Wenzhou,Zhejiang 325000,China;Department of Hepatobiliary Surgery,the First Affiliated Hospital of Wenzhou Medical University,Wenzhou,Zhejiang 325000,China)
出处
《肝胆胰外科杂志》
CAS
2020年第11期672-675,685,共5页
Journal of Hepatopancreatobiliary Surgery
基金
温州市科技计划项目(Y20180495)
温州医科大学附属第二医院“双五”临床研究专项基金(SAHoWMU-CR2018-02-227)。
关键词
肝内胆管癌
中性粒细胞/淋巴细胞比值
胆管结石
生存率
intrahepatic cholangiocarcinomas
neutrophil-lymphocyte ratio
hepatolithiasis
survival rate
