【摘要】 目的：基于血常规指标构建结直肠癌患者根治术后复发的列线图模型，并对其进行效能评估。方法：回顾性分析2021年1月至2023年12月于焦作市人民医院接受结直肠癌根治术治疗的325例结直肠癌患者的临床资料。所有患者均随访1年，根据复发情况分为复发组和未复发组。比较两组患者的一般资料及血常规指标，采用COX回归模型检验各因素对结直肠癌术后复发的影响并构建结直肠癌术后复发的列线图模型。结果：325例患者中105例复发，纳入复发组，220例未复发，纳入未复发组；复发组患者TNM分期为Ⅲ～Ⅳ期、低分化及有淋巴结转移占比高于未复发组，差异具有统计学意义（P<0.05）；手术前后，复发组患者淋巴细胞与单核细胞比值（LMR）均低于未复发组，中性粒细胞与淋巴细胞比值（NLR）、血小板与淋巴细胞比值（PLR）均高于未复发组，差异具有统计学意义（P<0.05）;COX回归分析显示，TNMⅢ～Ⅳ期、低分化、淋巴结转移及NLR、PLR高水平是结直肠癌术后复发的危险因素（HR > 1,P<0.05）,LMR高水平是结直肠癌术后复发的保护因素（HR<1,P<0.05）；基于LMR、NLR、PLR构建的列线图模型预测结直肠癌患者根治术后复发的曲线下面积（AUC）为0.841，具有一定的预测价值。结论：TNMⅢ～Ⅳ期、低分化、淋巴结转移及NLR、PLR高水平是结直肠癌术后复发的危险因素，LMR高水平是结直肠癌术后复发的保护因素，基于LMR、NLR、PLR构建的列线图模型具有一定的预测价值。更多还原

【Abstract】 Objective To construct a nomogram model for predicting postoperative recurrence of colorectal cancer based on blood routine indicators and evaluate its efficacy.Methods The clinical data of 325 patients with colorectal cancer who underwent radical resection at Jiaozuo People’s Hospital from January 2021 to December 2023 were retrospectively analyzed.All patients were followed up for 1 year and were divided into a recurrence group and a non-recurrence group based on the recurrence status.The general data and blood routine indicators of the two groups were compared.The COX regression model was used to test the influence of each factor on postoperative recurrence of colorectal cancer and to construct a nomogram model for predicting postoperative recurrence of colorectal cancer.Results Among the 325 patients,105 cases recurred and were included in the recurrence group,and 220 cases did not recur and were included in the non-recurrence group.The proportions of patients with TNM stage Ⅲ-Ⅳ,poorly differentiated,and lymph node metastasis in the recurrence group were higher than those in the non-recurrence group,and the differences were statistically significant(P <0.05).Before and after surgery,the lymphocyte to monocyte ratio(LMR) of patients in the recurrence group was lower than that in the non-recurrence group,and the NLR and PLR were higher than those in the nonrecurrence group,and the differences were statistically significant(P <0.05).COX regression analysis showed that TNM stage Ⅲ-Ⅳ,poorly differentiated,lymph node metastasis,and high levels of neutrophil to lymphocyte ratio(NLR) and platelet to lymphocyte ratio(PLR) were risk factors for postoperative recurrence of colorectal cancer(HR> 1,P <0.05),and high levels of LMR were protective factors for postoperative recurrence of colorectal cancer(HR <1,P <0.05).The nomogram model based on LMR,NLR,and PLR had an area under the curve(AUC) of 0.841 for predicting postoperative recurrence of colorectal cancer after radical resection,indicating a certain predictive value.Conclusion TNM stage Ⅲ-Ⅳ,poorly differentiated,lymph node metastasis,and high levels of NLR and PLR are risk factors for postoperative recurrence of colorectal cancer,and high levels of LMR are protective factors for postoperative recurrence of colorectal cancer.The nomogram model based on LMR,NLR,and PLR has a certain predictive value.更多还原