手术前后红细胞分布宽度与淋巴细胞计数比值对非转移性结直肠癌患者预后判断的价值

来源 :肿瘤研究与临床 | 被引量 : 0次 | 上传用户:niujicun
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目的:探讨手术前后红细胞分布宽度与淋巴细胞计数比值(RLR)对非转移性结直肠癌患者无病生存(DFS)的预测价值。方法:回顾性分析解放军总医院海南医院2012年12月至2020年1月经术后病理确诊的108例非转移性结直肠腺癌患者资料,计算RLR,分析不同临床病理特征患者RLR差异。采用受试者工作特征(ROC)曲线分析手术前后RLR对患者DFS的预测价值,根据约登指数确定RLR界值;按RLR界值分层,Kaplan-Meier法分析不同分层患者间DFS,并行log-rank检验。采用Cox比例风险回归模型进行单因素和多因素分析。结果:手术前后RLR对患者DFS预测的约登指数分别为8.86%和9.15%,以此分为术前RLR<8.86%组(73例)和术前RLR ≥8.86%组(35例)、术后RLR<9.15%组(48例)和术后RLR ≥9.15%组(60例)。经ROC曲线分析,手术前后RLR预测患者DFS的曲线下面积(AUC)分别为0.66(95%n CI 0.55~0.77,n P=0.01)和0.62(95% n CI 0.51~0.74,n P=0.04),以手术前后RLR界值预测患者3年DFS率的灵敏度分别为51.60%和71.00%,特异度分别为76.60%和50.60%。经Kaplan-Meier法分析,术前RLR<8.86%组DFS优于RLR ≥8.86%组(n χ2=7.35,n P<0.01),而术后RLR ≥9.15%组和<9.15%组间DFS差异无统计学意义(n χ2=3.69,n P=0.06)。术前RLR是患者DFS独立影响因素(n HR=1.13,95% n CI 1.04~1.22,n P<0.01)。n 结论:手术前后RLR对非转移性结直肠癌患者3年DFS率预测有一定的价值,术前RLR是患者DFS的独立影响因素,RLR较低的患者预后较好。“,”Objective:To explore the value of pre- and postoperative red cell distribution width-to-lymphocyte count ratio (RLR) in predicting the disease-free survival (DFS) for non-metastatic colorectal cancer patients.Methods:The data of 108 patients pathologically diagnosed with non-metastatic colorectal adenocarcinoma after surgery from December 2012 to January 2020 in Hainan Hospital of PLA General Hospital were retrospectively analyzed. RLR was calculated and its differences in patients with varied clinicopathological characteristics were analyzed. The receiver operating characteristics (ROC) curve was applied to analyze the value of pre- and postoperative RLR in predicting DFS of patients, and the cut-off value was determined by Youden index. DFS of patients with different stratification stratified by a cut-off value of RLR was analyzed by using Kaplan-Meier method followed by log-rank test. Cox proportional hazards model was used to make univariate and multivariate analysis.Results:Youden index of pre- and postoperative RLR in predicting DFS was 8.86%, 9.15%; based on the above index, the patients were divided into the preoperative RLR<8.86% group (73 cases) and preoperative RLR≥8.86% group (35 cases), postoperative RLR<9.15% group (48 cases) and postoperative RLR≥9.15% group (60 cases). According to ROC curve, the area under the curve (AUC) of preoperative RLR in predicating DFS was 0.66 (95%n CI 0.55-0.77, n P = 0.01), and AUC of postoperative RLR in predicating DFS was 0.62 (95% n CI 0.51-0.74, n P = 0.04). Pre- and postoperative RLR cut-off values were used to predict 3-year DFS rate of patients with the sensitivity of 51.60% and 71.00%, respectively, and the specificity of 76.60% and 50.60%, respectively. Kaplan-Meier analysis showed that patients in preoperative RLR<8.86% group had a better DFS compared with those in preoperative RLR≥8.86% group (n χ2 = 7.35, n P < 0.01); there was no statistical difference in DFS between postoperative RLR<9.15% group and postoperative RLR≥9.15% group ( n χ2 = 3.69, n P = 0.06). Preoperative RLR was an independent affecting factor for DFS of patients (n HR = 1.13, 95% n CI 1.04-1.22, n P <0.01).n Conclusions:Pre- and postoperative RLR could be useful in predicating 3-year DFS for patients with non-metastatic colorectal cancer. Preoperative RLR is an independent affecting factor for DFS, and the patients with low RLR have a better prognosis.
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