【摘要】 目的 探究血小板分布宽度及乳酸脱氢酶在结直肠癌伴肝转移患者的预后预测的价值。方法 回顾性分析收集广西壮族自治区南溪山医院2019年1月—2022年9月消化内科收治的46例结直肠癌伴肝转移患者为研究对象，所有患者经病理学确诊为结直肠癌伴肝转移，收集并整理所有患者的临床资料，包括年龄、性别、血小板分布宽度、乳酸脱氢酶等，对患者进行为其2年的随访，根据2年随访终点患者的生存结局作为分组依据，分为生存组与死亡组。使用IBM SPSS 23.0统计分析应用软件对临床数据资料开展统计学数据处理，采用COX比例风险模型对结直肠癌伴肝转移患者进行多因素分析，并将多因素结果纳入ROC曲线分析中，对结直肠癌伴肝转移患者的预后进行预测价值分析。结果 46例结直肠癌伴肝转移患者中，截止随访2年到期，其中27例生存，19例死亡，生存组与死亡组临床资料中年龄、性别、体质量指数（BMI）、T分期、分级、白蛋白、血小板计数、中性粒细胞/淋巴细胞比值(NLR)、血小板/淋巴细胞比值(PLR)及淋巴细胞/单核细胞比值(LMR)数据对比，差异无统计学意义（P>0.05）；血小板分布宽度、乳酸脱氢酶数据对比，死亡组更高，差异有统计学意义（P<0.05）。经上述单因素分析结果显示，血小板分布宽度、乳酸脱氢酶是影响采用综合治疗结直肠癌伴肝转移患者的预后危险因素，将两组数据纳入多因素分析中，结果显示血小板分布宽度、乳酸脱氢酶均可作为结直肠癌伴肝转移患者治疗的预后独立危险因素（95%CI 1.000～1.022、95%CI 1.071～1.557,P<0.05）。ROC曲线显示，两个指标单独预测价值均较高，logistic回归分析结果显示，联合指标应用对于结直肠癌伴肝转移预后的预测价值更高，且联合预测价值较单一指标有所提升。结论 血小板分布宽度及乳酸脱氢酶单一指标可以作为结直肠癌伴肝转移术患者预后的预测，但联合指标预测价值更高。更多还原

【Abstract】 Objective To investigate the value of platelet distribution width and lactate dehydrogenase in predicting the prognosis of patients with colorectal cancer with liver metastases. Methods Retrospective analysis was performed to collect forty-six patients with colorectal cancer with liver metastases admitted to the Department of Gastroenterology, Nanxishan Hospital of Guangxi Zhuang Autonomous Region from January 2019 to September 2022 as the subjects of this study. All patients were pathologically confirmed as colorectal cancer with liver metastasis. The clinical data of all patients, including age, gender, platelet distribution width, and lactate dehydrogenase, were collected and collated, and the patients were followed up for their 2 years. Patients were divided into survival and death groups based on their survival outcomes at the 2-year follow-up endpoint as the basis for grouping. Statistical data processing of clinical data was performed using IBM SPSS 23.0 statistical analysis application. A COX proportional risk model was used to perform multifactorial analysis of patients with colorectal cancer with liver metastases. And the multifactorial results were included in the ROC curve analysis to analyze the prognosis of colorectal cancer with liver metastasis patients for predictive value. Results Among forty-six patients with colorectal cancer with liver metastasis, twentyseven of them survived and nineteen of them died by the end of 2 years of follow-up. In the clinical data of the survival and death groups, there were no statistical differences in age, sex, body mass index(BMI), T stage, grading, albumin, platelet count, neutrophil/lymphocyte ratio(NLR), platelet/lymphocyte ratio(PLR) and lymphocyte/monocyte ratio(LMR) data(P>0.05); compared with platelet distribution width and lactate dehydrogenase data, the death group was higher, the difference was statistically significant(P<0.05). The results of the above univariate analysis showed that platelet distribution width and lactate dehydrogenase were prognostic risk factors affecting patients with colorectal cancer with liver metastases treated with combination therapy. When the data from both groups were included in the multifactorial analysis, the results showed that platelet distribution width and lactate dehydrogenase could be independent risk factors for the prognosis of patients with colorectal cancer with liver metastases treated(95%CI 1.000～1.022,95%CI 1.071～1.557, P<0.05). The ROC curve shows that both indicators have higher predictive value alone. The results of logistic regression analysis show that the application of combined indicators has higher predictive value for the prognosis of colorectal cancer with liver metastasis, and the combined predictive value has improved compared to a single indicator. Conclusion Platelet distribution width and lactate dehydrogenase can be used as single indicators to predict the prognosis of patients with colorectal cancer with liver metastasis, but the combined indicators have higher predictive value.更多还原