摘要
目的 探讨术前炎症指标血小板与淋巴细胞比值(PLR)、中性粒细胞与淋巴细胞比值(NLR)、C反应蛋白(CRP)、系统免疫炎症指数(SII)对肝细胞癌(HCC)术后患者早期复发的预测价值。方法 回顾性分析2014年1月至2015年12月在广西医科大学附属肿瘤医院进行HCC切除术治疗的患者的临床资料。通过受试者工作特征(ROC)曲线及Cox比例风险模型评价术前炎症指标PLR、NLR、CRP、SII对HCC患者术后早期复发的辅助诊断和预测价值。采用Kaplan-Meier曲线比较不同水平炎症指标患者的术后无病生存期。结果 研究共纳入174例患者,其中80例(46.0%)患者为早期复发,94例(54.0%)患者为非早期复发。术前炎症指标预测HCC患者术后早期复发的ROC曲线显示,PLR的曲线下面积(AUC)为0.521(95%CI:0.434~0.608),NLR的AUC为0.527(95%CI:0.441~0.614),CRP的AUC为0.660(95%CI:0.578~0.742,P<0.001),SII的AUC为0.668(95%CI:0.588~0.747,P<0.001)。Kaplan-Meier曲线显示高水平PLR组(PLR>88.3)、高水平NLR组(NLR>2.7)、高水平CRP组(CRP>1.85 mg/L)、高水平SII组(>65.71)患者复发率高于低水平组患者。多因素Cox比例风险模型显示高水平NLR、SII为HCC患者术后早期复发的独立危险因素,而高水平PLR及CRP不是影响早期复发的独立危险因素。结论 术前NLR、SII对HCC切除术后早期复发有一定的预测价值,高水平NLR、SII是预后不良的重要指标。
Objective To explore the predictive value of preoperative inflammatory indicators such as platelet-to-lymphocyte ratio(PLR),neutrophil-to-lymphocyte ratio(NLR),C-reactive protein(CRP),and systemic immune-inflammation index(SII)for early recurrence in patients with hepatocellular carcinoma(HCC)after surgery.Methods Retrospective analysis was carried out on the clinical data of patients who underwent hepatectomy in the Affiliated Cancer Hospital of Guangxi Medical University from January 2014 to December 2015.And then,the auxiliary diagnostic and predictive value of preoperative inflammatory indicators including PLR,NLR,CRP,and SII for early postoperative recurrence in HCC patients were evaluated through receiver operating characteristic(ROC)curves and Cox proportional hazards models.In addition,the postoperative disease-free survival of patients with different levels of inflammatory indicators was compared by Kaplan-Meier.Results A total of 174 patients were included in the study,of which 80 patients(46.0%)experienced early recurrence,and 94 patients(54.0%)experienced non early recurrence.The ROC curve for predicting early postoperative recurrence in HCC patients based on preoperative inflammatory indicators showed that the area under the curve(AUC)of PLR was 0.521(95%CI:0.434–0.608),the AUC of NLR was 0.527(95%CI:0.441–0.614),the AUC of CRP was 0.660(95%CI:0.578–0.742,P<0.001),and the AUC of SII was 0.668(95%CI:0.588–0.747,P<0.001).Kaplan Meier curve showed that the recurrence rates of patients in high-level PLR group(PLR>88.3),high-level NLR group(NLR>2.7),high-level CRP group(CRP>1.85 mg/L),and high-level SII group(>65.71)were higher than that of patients in low-level group.Multivariate Cox proportional hazards model showed that high levels of NLR and SII were independent risk factors for early postoperative recurrence in HCC patients,while high levels of PLR and CRP were not independent risk factors for early recurrence.Conclusion Preoperative NLR and SII have certain predictive value for early recurrence after HCC hepatectomy,and high levels of NLR and SII are important indicators of poor prognosis.
作者
王宗佳
杨国海
黄宇
林燕
李永强
骆敏
WANG Zongjia;YANG Guohai;HUANG Yu;LIN Yan;LI Yongqiang;LUO Min(Department of Gastrointestinal Oncology,Affiliated Cancer Hospital of Guangxi Medical University,Nanning 530021,Guangxi,China;State Key Laboratory of Targeting Oncology,Guangxi Medical University,Nanning 530021,Guangxi,China)
出处
《右江医学》
2025年第2期115-121,共7页
Chinese Youjiang Medical Journal
基金
广西医科大学附属肿瘤医院青年科学基金资助项目(院青2021-06号)
广西医疗卫生重点学科建设项目(桂卫科教发[2022]4号)
广西医疗卫生适宜技术开发与推广应用项目(S2021015)。
关键词
肝细胞癌
炎症指标
血小板与淋巴细胞比值
中性粒细胞与淋巴细胞比值
C反应蛋白
系统免疫炎症指数
hepatocellular carcinoma(HCC)
inflammatory markers
platelet-to-lymphocyte ratio(PLR)
neutrophil-to-lymphocyte ratio(NLR)
C-reactive protein(CRP)
systemic immune inflammation index(SII)
