全身炎性反应与直肠癌术后生存率的相关分析

doi:10.3969/j.issn.1005-6483.2019.05.012

摘要/Abstract

摘要： 目的：分析炎性反应预后评分（IPS）与直肠癌术后生存率的相关性。方法：直肠癌根治术术后病人678例，收集病人入院后第2天外周静脉血血常规、肝功能等资料，依次计算出炎性反应评分——NLR、DNLR、PLR、LMR、COPNLR及PNI等指标，依据IPS依次计算出各自得分。以5年生存时间作为终点绘制IPS的实验对象作指征（ROC）曲线，以此作为研究对象，术前IPS预测5年生存率的最佳截点，并依据该临界值将病人分为高IPS组和低IPS组，比较高低两组直肠癌术后病人在手术方式、肿瘤TNM分期、肿瘤大小及形态、侵及深度、肿瘤距肛缘的距离等指标的关系。然后采用COX比例风险回归模型对组成IPS的各因素进行单因素和多因素分析。结果：IPS诊断死亡危险事件的受试者工作特征曲线下面积（ROCAUX）为0.781，截点为2.5。根据2.5截点分为低IPS组、高IPS组。两组年龄分别为（59.1±11.9）岁、（59.5±9.8）岁。两组间TNM分期比较，差异有统计学意义。多因素COX风险回归模型显示男性、NLR、DNLR、COPNLR评分为危险因素，HR分别为1.489、4.027、2.208、2.188。LMR评分为保护性因素，HR为0.559。结论：IPS水平与直肠癌术后生存率相关，高IPS提示预后不良。

关键词: 直肠癌, 炎性反应细胞, 营养指数, 预后

Abstract: Objective：Correlation analysis of Inflammationbased prognostic scores（IPS）in survival rate after rectal cancer surgery.Methods：A retrospective cohort was used to analyze the patients who underwent radical resection of rectal cancer.A total of 678 patients were enrolled.Peripheral venous blood routine and liver function on the second day after admission，the inflammation scores  NLR，DNLR，PLR，LMR，COPNLR and PNI were calculated in turn，based on widely accepted inflammatory prognosis scores.（IPS），which calculates their respective scores in turn.The 5year survival time was used as the endpoint of the inflammatory prognostic score（IPS）.The index of the index（ROC）was used as the cutoff point for predicting the 5year survival time of the preoperative inflammatory prognostic score（IPS）.According to the threshold，the patients were divided into highinflammation prognostic score（IPS）group and lowinflammation prognosis score（IPS）group.The surgical methods，tumor TNM stage，tumor size and morphology，and invasion were compared between the two groups.And the relationship between the depth，the distance of the tumor from the anal margin，and other indicators.Then，the COX proportional hazard regression model was used to analyze the factors that constitute the inflammatory prognostic score（IPS）by univariate and multivariate analysis.Results：The area under the receiver operating characteristic curve for IPS diagnosis of death risk events（ROCAUX）was 0.781 and the cutoff point was 2.5.According to the 2.5 intercept points，it is divided into low IPS group and high IPS group.The age of the two groups was（59.1±11.9）years and（59.5±9.8）years，respectively.There was a statistically significant difference in TNM staging between the two groups.The multivariate COX risk regression model showed male，NLR，DNLR and COPNLR score as risk factors，and HR were 1.489，4.027，2.208 and 2.188，respectively.The LMR score was a protective factor with an HR of 0.559.Conclusion：Preoperative inflammatory outcome score（IPS）is associated with postoperative survival in rectal cancer.High inflammatory prognostic score（IPS）suggests a poor prognosis.

Key words: rectal carcinoma, inflammatory cell, nutritional index, prognosis

罗志民, 张家驹, 赵恩宏. 全身炎性反应与直肠癌术后生存率的相关分析[J]. 临床外科杂志, 2019, 27(5): 395-398.

参考文献

相关文章 15

[1]	王家欢, 汪洋. 近端胃切除加幽门成形术对近端胃癌病人胃食管反流及营养的影响[J]. 临床外科杂志, 2019, 27(5): 387-389.
[2]	张明府, 吴永丰, 柳东. 腹腔镜直肠癌前切除术中保留左结肠动脉对术后吻合口漏及近期疗效的影响[J]. 临床外科杂志, 2019, 27(5): 400-403.
[3]	周东, 何艳平, 李恒平, 黄卫东. 不同腹腔镜胃癌根治术对原发性胃癌病人胃肠动力、炎性应激及预后的影响分析[J]. 临床外科杂志, 2019, 27(5): 436-438.
[4]	欧阳学哲, 刘慧. 雄激素受体在三阴性乳腺癌中的表达及预后意义[J]. 临床外科杂志, 2019, 27(3): 227-230.
[5]	汪玲, 潘华锋, 李琰. 不同分子分型乳腺癌临床病理特征及预后分期分析[J]. 临床外科杂志, 2019, 27(3): 231-234.
[6]	唐浩, 崔君鹏, 刘宝林. 腹部Castleman病九例[J]. 临床外科杂志, 2019, 27(3): 269-269.
[7]	房渝, 吴庆琛, 秦治明. 巨大纵隔肿瘤31例治疗体会[J]. 临床外科杂志, 2019, 27(2): 146-148.
[8]	秦新裕, 许剑民, 任黎, 常文举. 2018版《中国结直肠癌肝转移诊断和综合治疗指南》解读[J]. 临床外科杂志, 2019, 27(1): 9-13.
[9]	饶慕圣曹胜华王学成. 肛管直肠恶性黑色素瘤一例[J]. 临床外科杂志, 2018, 26(11): 891-891.
[10]	. 中低位直肠癌新辅助治疗的个体化选择[J]. 临床外科杂志, 2018, 26(10): 733-734.
[11]	曹金鹏杨平余思李志澄朱佳成罗特东计勇. 不同微创术式治疗高龄直肠癌病人的疗效及对其免疫炎性反应及预后的影响分析[J]. 临床外科杂志, 2018, 26(10): 751-753.
[12]	任朋张烨陶建新沈仁辉王彤. 吲哚菁绿显像对减少腹腔镜结直肠癌根治术后吻合口漏的作用[J]. 临床外科杂志, 2018, 26(10): 754-756.
[13]	赵家运王志刚潘乐玉. 限制性输血对直肠癌保肛术后并发症影响分析[J]. 临床外科杂志, 2018, 26(10): 763-766.
[14]	陶俊王贵和. 局部进展期直肠癌新辅助放化疗后病理完全缓解的预测因素分析[J]. 临床外科杂志, 2018, 26(10): 756-759.
[15]	张文斌李翔. 手辅助腹腔镜在肥胖结直肠癌患者中的应用价值及疗效分析[J]. 临床外科杂志, 2018, 26(10): 760-763.

Metrics

Viewed

Full text

Abstract

Cited

Shared

Discussed