【摘要】 目的 :探讨中性粒细胞/淋巴细胞比值(neutrophil-to-lymphocyte ratio,NLR)与早期原发性肝细胞癌(hepatocellular carcinoma,HCC)临床病理特征及预后的相关性。方法 :收集113例早期HCC患者与110例乙型肝炎肝硬化患者的临床资料。比较2组患者间甲胎蛋白(alpha-fetoprotein,AFP)表达量、乙型肝炎病毒(hepatitis B virus,HBV)-DNA、HCC病理分级和NLR等病理指标的差异。分析不同NLR(NLR<3.65与NLR≥3.65)之间HCC患者无瘤生存率和总生成率的差异,并通过logistic回归分析影响HCC发生的因素,COX回归分析影响HCC术后复发的因素。结果 :NLR在HCC组及乙型肝炎肝硬化组间差异有统计学意义(t=3.546,P<0.05);Spearman相关分析结果显示,NLR高低与病理分化程度呈负相关(r=-0.408,P<0.001)。log-rank检验分析结果显示,不同的NLR(NLR<3.65与NLR≥3.65)组间HCC术后无瘤生存率差异有统计学意义(χ~2=40.838,P<0.001),而总生存率差异无统计学意义(χ~2=0.046,P>0.05);多因素logistic回归分析显示,NLR、谷丙转氨酶(alanine transaminase,ALT)及γ-谷氨酰转肽酶(γ-glutamyl transferase,γ-GGT)对HCC发生有影响;COX回归分析结果显示,NLR和HCC复发有关(比值比为2.271,P<0.01)。结论 :NLR高低与HCC的发生具有相关性,NLR越高HCC的分化程度越低,且术后3年内复发率越高,但与术后3年总生成率无关。更多还原

【Abstract】 Objective:To explore the correlation of neutrophil-to-lymphocyte ratio(NLR) with the clinicopathological characteristics and prognosis of early primary hepatocellular carcinoma(HCC).Methods:The clinical data of 1 1 3 patients with early HCC and 110 patients with hepatitis B cirrhosis were collected.The expression of alpha-fetoprotein(AFP),copy number of hepatitis B virus(HBV)-DNA,pathological grade of HCC tissues,NLR and other pathological indicators between the two groups were compared.The differences in disease-free survival rate and overall survival rate were analyzed between the different levels of NLR(NLR < 3.65 vs NLR >3.65).The factors influencing the occurrence of HCC were analyzed by logistic regression,while the factors influencing the postoperative recurrence of HCC were analyzed by COX regression.Results:A significant difference in NLR was found between HCC and hepatitis B cirrhosis groups(f = 3.546,P < 0.05).Spearman correlation analysis showed that NLR was negatively correlated with the pathological differentiation degree of HCC(r =-0.408,P < 0.001).Logrank analysis showed that the postoperative disease-free survival rate of HCC patients was significantly different according to the different NLR(χ~2= 40.838,P < 0.001),but the overall survival rate was not significantly different(χ~2 = 0.046,P > 0.05).Multivariate logistic regression analysis showed that the occurrence of HCC had been influenced by NLR,alanine transaminase(ALT) and γ-glutamyl transferase(γ-CCT).COX regression analysis showed that NLR was correlated with the recurrence of HCC(odds ratio = 2.271,P < 0.01).Conclusion:NLR is correlated with the occurrence of HCC.The higher the NLR,the lower the differentiation degree of HCC,and the higher the recurrence rate of HCC patients in 3 years after surgery.But the overall survival rate of HCC patients in 3 years after operation is not associated with NLR.更多还原