首页|中性粒细胞-淋巴细胞比值和老年营养风险指数用于预测结直肠癌患者预后的价值

中性粒细胞-淋巴细胞比值和老年营养风险指数用于预测结直肠癌患者预后的价值

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目的 探讨中性粒细胞-淋巴细胞比值(NLR)和老年营养风险指数(GNRI)用于预测结直肠癌患者预后的价值.方法 选取 2019 年 5 月至 2021 年 1 月于武汉市红十字会医院诊治且随访至 2023 年 12 月的结直肠癌患者 103 例作为研究对象,设立为结直肠癌组,同期选取 52 例健康体检者设立为对照组.对比NLR、GNRI变化;比较不同病理特征结直肠癌患者的NLR、GNRI变化;Kendall's tau-b相关性检验分析NLR、GNRI与临床特征的相关性;采用Cox回归风险模型分析NLR、GNRI对结直肠癌患者预后的影响;采用Logistic回归构建NLR、GNRI两项联合参数,并绘制受试者操作特征(ROC)曲线分析NLR、GNRI及两项联合预测预后的效能.结果 结直肠癌组的NLR、GNRI低于对照组(P<0.05).103 例结直肠癌患者无进展生存期为(30.98±8.27)个月,总生存期为(32.91±6.09)个月,3 年无进展生存率为 71.84%(74/103),3 年总生存率为 77.67%(80/103).不同年龄、分化程度、临床分期、淋巴结转移、白蛋白的结直肠癌患者NLR、GNRI比较,差异具有统计学意义(P<0.05).Kendall's tau-b相关性分析显示,NLR与结直肠癌患者的年龄、分化程度、临床分期、淋巴结转移呈正相关,与白蛋白水平呈负相关(P<0.05);GNRI与结直肠癌患者年龄、分化程度、临床分期呈负相关,与白蛋白水平呈正相关(P<0.05).Cox回归风险模型分析显示,NLR升高和GNRI下降为结直肠癌患者 3 年无进展生存率及总生存率的独立影响因素(P<0.05).ROC曲线分析显示,NLR、GNR及两项联合预测结直肠癌患者预后的AUC值分别为 0.732、0.693、0.808(P<0.05);敏感度分别为 69.60%、60.90%、65.20%;特异度分别为 93.70%、96.20%、98.80%.结论 NLR升高和GNRI下降会对结直肠癌患者预后产生不利影响,动态观察其变化有利于为临床治疗和预后评估提供指导.
The value of neutrophil-lymphocyte ratio and geriatric nutritional risk index in predicting prognosis in patients with colorectal cancer
Objective To investigate the value of neutrophil-lymphocyte ratio(NLR)and geriatric Nutritional risk index(GNRI)in predicting the prognosis of patients with colorectal cancer.Method A total of 103 patients with colorectal cancer who were diagnosed and treated in Wuhan Red Cross Hospital from May 2019 to January 2021 and followed up to December 2023 were selected as the study objects and set as the colorectal cancer group,and 52 healthy subjects were selected as the control group during the same period.Compare the changes of NLR and GNRI.The changes of NLR and GNRI in colorectal cancer patients with different pathological characteristics were compared.Kendall's tau-b method was used to analyze the correlation between NLR,GNRI and clinical features.Cox regression risk model was used to analyze the effects of NLR and GNRI on the prognosis of colorectal cancer patients.The combined parameters of NLR and GNRI were constructed by Logistic regression,and receiver operating characteristic(ROC)curves were drawn to analyze the efficacy of NLR,GNRI and the combined prediction of prognosis.Result The NLR and GNRI in colorectal cancer group were lower than those in control group(P<0.05).The progression-free survival of 103 patients with colorectal cancer was(30.98±8.27),the overall survival was(32.91±6.09)months,the 3-year progression-free survival rate was 71.84%(74/103),and the 3-year overall survival rate was 77.67%(80/103).There were statistically significant differences in NLR and GNRI among colorectal cancer patients with different age,differentiation degree,clinical stage,lymph node metastasis and albumin(P<0.05).Kendall's tau-b correlation analysis showed that NLR was positively correlated with age,differentiation,clinical stage and lymph node metastasis of colorectal cancer patients,and negatively correlated with albumin(P<0.05).GNRI was negatively correlated with age,differentiation and clinical stage of colorectal cancer patients,and positively correlated with albumin(P<0.05).Cox regression risk model analysis showed that the increase of NLR and the decrease of GNRI were independent influencing factors for 3-year disease-free survival and overall survival of colorectal cancer patients(P<0.05).ROC curve analysis showed that the AUC values of NLR,GNR and the combination of NLR and GNR were 0.732,0.693 and 0.808,respectively,P<0.05.Sensitivity was 69.60%,60.90%,65.20%.The specificity was 93.70%,96.20%and 98.80%.Conclusion The increase of NLR and the decrease of GNRI have adverse effects on the prognosis of colorectal cancer patients,and dynamic observation of their changes is conducive to providing guidance for clinical treatment and prognosis assessment.

Neutrophil-lymphocyte ratioNutritional statusColorectal cancerPrognosisNutritional risk index of the elderlyTumor stagingPredictive valueClinical guidance

李伟、邓浩、李威、刘小卫

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武汉市红十字会医院普外科,湖北 武汉 430000

中性粒细胞-淋巴细胞比值 营养状况 结直肠癌 预后 老年营养风险指数 肿瘤分期 预测价值 临床指导

武汉市医学科研项目

WX21D43

2024

肿瘤代谢与营养电子杂志

肿瘤代谢与营养电子杂志

CSTPCD
ISSN:
年,卷(期):2024.11(4)
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