【作者】 陈卓；

【导师】 涂小煌；

【作者基本信息】 福建医科大学 ， 外科学（普外）（专业学位）， 2018， 硕士

【摘要】 目的:探讨结直肠癌患者术前外周血中性粒细胞和淋巴细胞比值(NLR)与术P53与Ki-67表达特征、术后病理及其预后的相关性及其临床意义。利用术前NLR可为结肠癌患者进展程度及其预后的评估提供参考。方法:回顾性收集2009年10月至2012年10月在我院普通外科行结直肠癌根性除手术治疗并且术前未行放化疗的患者共124例,根据患者术前外周血NLR分成高NLR值(>3.3)组和低NLR值(≤3.3)组,分别分析低NLR值组与高NLR值组中在结直肠癌组织中的表达情况。并分别分析比较其预后情况。Kaplan-Meier法进行总生存时间分析,分别作出生存曲线,Cox回归分析筛选结直肠癌的独立预后因素,用Spearman等级资料的相关性分析NLR与蛋白表达的相关性。结果:高NLR值的患者64例,占29.6%;低NLR值的患者共60例,占70.4%。在高NLR组患者中为晚期的T分期(P<0.001)、N分期(P<0.001)及TNM分期(P<0.001)、p53和Ki67高阳性表达率(p<0.001)。5年总体生存率在高NLR组患者为35%,而5年总体生存率在低NLR组为87.5%,差异有显著性(P<0.001)。多因素分析显示,年龄超过65岁(P<0.001)、较晚的N分期(P=0.004)、较晚的TNM分期(P=0.005)(P<0.001)、高NLR值(P=0.03)、Ki67高阳性表达是结直肠癌预后的独立因素。结论:高NLR值组中结直肠癌组织中P53及Ki67的表达呈高阳性表达占的例数多。术前NLR值与结直肠癌组织中P53与Ki67之间存在相关性,呈负相关。高NLR值是结直肠癌的独立危险因素。中性粒细胞与淋巴细胞比率(NLR)增高(NLR>3.3)提示肿瘤预后不良的指标。更多还原

【Abstract】 Purpose:To explore the prognostic significance of preoperative neutrophil-lymphocytes ratio(NLR)in patients with colorectal cancer.Method:Methods a retrospective study of radical resection of colorectal cancer in general surgery from October 2009 to October 2012 in our hospital was conducted.In addition to the surgical treatment and preoperative chemotherapy in patients with a total of 124 cases,All the patients were divided as high and low groups by the NLR with a cut-off value of 3.3.Kaplan-Meier method and Log-rank test was used to analyze and compare the overall survival and disease-free survival time.Cox regression was used to screen the independent prognostic factors for colorectal cancer.Result:64 patients(29.6%)had high NLR(more than 3.3)while 60 patients(70.4%)had low NLR(3.3 or less).High NLR patients showed the more advanced T stage(P<0.001)、 N(P<0.001)、TNM stage(P<0.001)、p53 and Ki67 high positive expression(P<0.001);The 5-year survival rate for patients with high NLR group was 35.0% and 87.5% in low NLR group,with significant difference(P<0.001).N stage(P=0.004)、TNM stage(P=0.005)、NLR(P=0.006)and Ki67 high positive expression(P=0.03)were independent prognostic factors for colorectal cancer.Conclusion:P53 and Ki67 were highly expressed in colorectal cancer tissues in the high NLR group.There was a negative correlation between nlr value before operation and p53 and Ki67 in colorectal cancer.And that NLR was independent prognostic factors for colorectal cancer.Patients with high NLR(>3.3)had poor prognosis.更多还原