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目的:探讨中性粒细胞/淋巴细胞比值(neutrophil-lymphocyte ratio,NLR)是否可以作为胆囊癌患者接受根治术后的预后指标.方法:回顾性分析2007-01/2010-06华中科技大学同济医院胆胰外科接受胆囊癌根治术治疗的胆囊癌患者的资料.根据患者术前外周静脉血NLR值分为低NLR组(NLR<5.0)和高N L R组(N L R≥5.0).比较两组患者的人口学、临床资料及病理学的差异.用单因素回归方法分析影响患者长期生存的变量,并将有统计学意义的变量导入COX多因素回归模型得到影响胆囊癌预后的独立危险因素.结果:本研究纳入了90例患者(低NLR组74例,高N L R组16例).低N L R组和高N L R组胆囊癌患者5年生存率分别为70.9%和27.6%(P<0.05).单因素分析显示肿瘤分化程度、淋巴结转移情况、侵犯肝脏、T分期、TNM分期、NRL(P<0.05)为影响胆囊癌预后的因素.COX多因素分析表明NLR是影响胆囊癌预后的独立危险因素(P<0.05).结论:NLR可以作为胆囊癌根治术后的预后因素,术前NLR≥5提示胆囊癌患者预后不良.
Objective: To investigate whether neutrophil-lymphocyte ratio (NLR) can be used as a prognostic indicator in patients with gallbladder cancer after radical operation.Methods: A retrospective analysis was performed between January 2007 and June 2010 with Tongji Hospital of Huazhong University of Science and Technology The data of gallbladder and pancreatic surgery patients with gallbladder carcinoma undergoing radical resection of gallbladder cancer were divided into low NLR group (NLR <5.0) and high NLR group (NLR≥5.0) based on the NLR of preoperative peripheral venous blood.Comparing the two groups Demographic, clinical data and pathology.Using single-factor regression analysis of variables that affect the long-term survival of patients, and statistically significant variables into COX multivariate regression model were independent risk factors affecting the prognosis of gallbladder.Results: Ninety patients (74 in the low NLR group and 16 in the high NLR group) were included in this study, and the 5-year survival rates were 70.9% and 27.6% for the patients with low NLR and high NLR, respectively (P <0.05) Analysis showed that the degree of tumor differentiation, lymph node metastasis, invasion of the liver, T stage, TNM stage, NRL (P <0.05) were the prognostic factors of gallbladder cancer.COX multivariate analysis showed that NLR was an independent risk factor for the prognosis of gallbladder cancer (P <0.05) .Conclusion: NLR can be used as a prognostic factor in the treatment of gallbladder carcinoma. The preoperative NLR≥5 indicates poor prognosis in patients with gallbladder cancer.