结肠癌术前中性粒细胞淋巴细胞比、血小板淋巴细胞比与淋巴结转移相关临床研究

发布时间：2018-06-21 12:25

  本文选题：结肠癌 + 中性粒细胞淋巴细胞比率　； 参考：《广西医科大学》2017年硕士论文

【摘要】：目的:探讨结肠癌患者术前中性粒细胞淋巴细胞比率(NLR)、血小板淋巴细胞比率(PLR)与淋巴结转移的关系,指导结肠癌患者术中淋巴结清扫。方法:选取2016年1月至2016年12月于广西医科大学第一附属医院结直肠肛门外科行结肠癌切除术的患者239例做回顾性研究,其中男性137例(57.30%),女性102例(42.70%),平均年龄58.30岁(27岁~91岁)。收集患者术前白细胞计数、中性粒细胞计数、血小板计数、淋巴细胞计数;收集患者术后病理信息,计算淋巴结转移率、转移度;绘制ROC曲线,通过最大约登指数确定NLR和PLR的临界值;通过临界值将病例分别分成高NLR组和低NLR组、高PLR组和低PLR组。分析术前NLR和PLR与临床病理之间的相关性;单因素及多因素分析淋巴结转移的相关因素。结果:1、根据ROC曲线,确定NLR、PLR的临界值分别是1.99、144.43。2、术前高NLR、PLR组与肿瘤大体类型、肿瘤直径、分化程度、组织分型、淋巴结分期、浸润深度、TNM分期、脉管侵犯等显著相关;3.单因素中肿瘤大体类型、肿瘤直径、分化程度、浸润深度、脉管侵犯、NLR、PLR等与淋巴结转移显著相关。多因素分析中分化程度、浸润深度、NLR、PLR是淋巴结转移的独立危险因素。结论:1、术前NLR、PLR的高低,可协助预测结肠癌患者淋巴结转移的程度,提高对术前淋巴结分期判断的准确性。2、NLR、PLR是最简明的生物学标志物,临床应用经济、便捷、可操作性强。可反映机体免疫功能和肿瘤进展状态,术前NLR、PLR增高常提示肿瘤临床分期晚。3、结肠癌患者术前NLR、PLR的高低,可指导结肠癌患者术中淋巴结清扫。4、NLR、PLR与结肠癌淋巴结转移的相关性及其机制的知识可能对癌症预防和治疗有用。
[Abstract]:Objective: to investigate the relationship between preoperative neutrophil lymphocyte ratio (NLR), platelet lymphocyte ratio (PLR) and lymph node metastasis in patients with colon cancer. Methods: a retrospective study was conducted in 239 patients who underwent colorectal and anal resection in the first affiliated Hospital of Guangxi Medical University from January 2016 to December 2016. There were 137 males (57.30m) and 102 females (42.70m), with an average age of 58.30 years (58.30 years) and 27 years (91 years). Collect preoperative leukocyte count, neutrophil count, platelet count, lymphocyte count, collect postoperative pathological information, calculate lymph node metastasis rate, draw ROC curve, The critical values of NLR and PLR were determined by the maximum Jordan index, and the cases were divided into high NLR group and low NLR group, high PLR group and low PLR group respectively. To analyze the correlation between preoperative NLR and PLR and clinicopathology, univariate and multivariate analysis of the related factors of lymph node metastasis. Results: according to the ROC curve, the critical value of NLR PLR was 1.99144.43.2. There was significant correlation between the preoperative high NLRL PLR group and tumor gross type, tumor diameter, differentiation degree, histological type, lymph node stage, depth of invasion, TNM stage, vascular invasion and so on. Tumor gross type, tumor diameter, differentiation degree, depth of invasion and vascular invasion of NLR PLR were significantly correlated with lymph node metastasis. In multivariate analysis, the degree of differentiation and the depth of invasion were independent risk factors for lymph node metastasis. Conclusion the level of preoperative NLRR PLR may help to predict the degree of lymph node metastasis in patients with colon cancer, and improve the accuracy of preoperative lymph node staging. It is the most concise biological marker. It is economical, convenient and operable in clinical application. It can reflect the immune function and the progress of tumor. The increase of NLRL PLR before operation often indicates that the clinical stage of tumor is late. 3. The level of NLRL PLR in patients with colon cancer before operation is higher than that in patients with colon cancer. The knowledge of the correlation and mechanism between lymph node dissection and lymph node metastasis in colon cancer patients may be useful for cancer prevention and treatment.
【学位授予单位】：广西医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R735.35

【参考文献】

中国期刊全文数据库 前5条

1 章志丹;张君严;鲁，

本文编号：2048605