术前NLR和PLR与肝门胆管癌根治术后临床病理特征及T分期的关系

李传涛; 周迟; 王兆映; 鲁正; 崔培元

doi:10.16766/j.cnki.issn.1674-4152.001993

术前NLR和PLR与肝门胆管癌根治术后临床病理特征及T分期的关系

doi: 10.16766/j.cnki.issn.1674-4152.001993

蚌埠医学院第一附属医院肝胆外科，安徽蚌埠 233004

基金项目:

安徽省自然科学基金 2008085MH256

详细信息

通讯作者:
崔培元, E-mail: Cpy666@126.com

中图分类号: R735.8
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- 文章访问数: 207
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- 被引次数: 0
出版历程
- 收稿日期: 2020-11-22
- 网络出版日期: 2022-02-16

Relationship between preoperative NLR and PLR and clinicopathological characteristics and T stage after laparoscopic radical resection of hilar cholangiocarcinoma

Department of Hepatobiliary Surgery, the First Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui 233004, China

摘要

摘要: 目的收集近10年本科室肝门胆管癌(HC)患者的病例资料。研究术前中性粒细胞与淋巴细胞比(NLR)和血小板与淋巴细胞比(PLR)与HC临床病理特征及T分期的关系。方法回顾性分析2010年1月—2019年12月在蚌埠医学院第一附属医院肝胆外科术后病理为HC患者的资料，共有100例患者被纳入。通过受试者工作特征(ROC)曲线确定NLR和PLR的最佳截止值，统计分析术前NLR和PLR与HC病理特征及T分期的关系, 以及对T分期的预测价值。结果 ROC曲线确定最佳截止值，高NLR组(NLR>4.12, 56例)和低NLR组(NLR≤4.12, 44例)；高PLR组(>184.56, 48例)和低PLR组(≤184.56，52例)。单因素分析表明，术前NLR与肿瘤位置和T分期有相关性(均P < 0.05)，与性别、年龄、分化程度、肿瘤大小等无关(均P > 0.05)；术前PLR与T分期、肿瘤大小和淋巴结转移有相关性(均P < 0.05), 与性别、年龄、分化程度、肿瘤位置等无关(均P > 0.05)。多因素分析结果表明，术前NLR与T分期(OR=2.999, P=0.026)和肿瘤位置(OR=0.346, P=0.032)有关；术前PLR与T分期(OR=3.635, P=0.007)和肿瘤大小(OR=1.728, P=0.031)有关，与淋巴结转移转移无关(P > 0.05)。术前NLR和PLR的ROC曲线面积为0.811和0.794，对T分期有预测价值。结论术前NLR和PLR是一种简单、实用的检测指标，可用于术前对HC病理特征的评估，对T分期有预测价值。
- 肝门胆管癌 /
- 中性粒细胞与淋巴细胞比 /
- 血小板与淋巴细胞比
Abstract: Objective To study the relationship between preoperative neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) with the clinicopathological characteristics and T staging of hilar cholangiocarcinoma (HC). Methods The data of patients with HC were analyzed retrospectively. The receiver operating characteristic (ROC) curve was used to determine the best cut-off values of NLR and PLR. Statistical analysis of preoperative NLR and PLR and HC pathological characteristics and the relationship between T staging and the predictive value of T staging. Results The ROC curve was used to determine the best cut-off value: high-NLR group (NLR>4.12, 56 cases), low-NLR group (NLR≤4.12, 44 cases), high-PLR group (>184.56, 48 cases) and low-PLR group (≤184.56, 52 cases). Univariate analysis showed that preoperative NLR was correlated with tumour location and T stage (all P < 0.05) and had no correlation with gender, age, degree of differentiation and tumour size (all P > 0.05). Preoperative PLR was correlated with T stage, tumour size and lymph node metastasis (all P < 0.05) and had no correlation with gender, age, degree of differentiation and tumour location (all P > 0.05). Multivariate analysis showed that preoperative NLR was associated with T staging (OR=2.999, P=0.026) and tumour location (OR=0.346, P=0.032). Preoperative PLR was related to T stage (OR=3.635, P=0.007) and tumour size (OR=1.728, P=0.031), but not to lymph node metastasis (P > 0.05). The ROC curve areas of NLR and PLR before surgery were 0.811 and 0.794, respectively, which have predictive value for T staging. Conclusion Preoperative NLR and PLR are simple and practical detection indicators that can be used to evaluate the pathological characteristics of HC before surgery and have predictive value for T staging.
- Hilar cholangiocarcinoma /
- Neutrophil-to-lymphocyte ratio /
- Platelet-to-lymphocyte ratio

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图 1 确定NLR和PLR最佳截止值的ROC曲线

下载: 全尺寸图片幻灯片

图 2 术前NLR和PLR与T分期的ROC曲线

下载: 全尺寸图片幻灯片

表 1 术前NLR水平与100例肝门胆管癌患者临床病理特征的关系(例)

项目	类别	例数	NLR		χ²值	P值
项目	类别	例数	高NLR组	低NLR组	χ²值	P值
性别	男性	67	39	28	0.402	0.526
	女性	33	17	16
年龄(岁)	>63	54	27	27	1.715	0.190
	≤63	46	29	17
分化程度	高	6	2	4
	中	73	42	31	1.332	0.906
	低	21	12	9
T分期	≥T2b	45	18	27	8.501	0.004
	<T2b	55	38	17
肿瘤大小(cm)	>2.5	45	30	15	3.778	0.052
	≤2.5	55	26	29
肿瘤位置	汇合部以上	52	35	17	5.622	0.018
	汇合部及以下	48	21	27
淋巴结转移	阳性	37	25	12	3.189	0.074
	阴性	63	31	32
TNM分期	>Ⅱ期	40	25	15	1.143	0.285
	≤Ⅱ期	60	31	29

下载: 导出CSV

表 2 术前PLR水平与100例肝门胆管癌患者临床病理特征的关系(例)

项目	类别	例数	PLR		χ²值	P值
项目	类别	例数	高PLR组	低PLR组	χ²值	P值
性别	男性	67	33	34	0.128	0.721
	女性	33	15	18
年龄(岁)	>63	54	22	32	2.478	0.115
	≤63	46	26	20
分化程度	高	6	1	5	4.046	0.132
	中	73	39	34
	低	21	8	13
T分期	≥T2b	45	14	31	9.350	0.002
	<T2b	55	34	21
肿瘤大小(cm)	>2.5	45	27	18	4.720	0.030
	≤2.5	55	21	34
肿瘤位置	汇合部以上	52	29	23	2.620	0.106
	汇合部及以下	48	19	29
淋巴结转移	阳性	37	24	13	6.692	0.010
	阴性	63	24	39
TNM分期	>Ⅱ期	40	24	16	2.620	0.106
	≤Ⅱ期	60	24	36

下载: 导出CSV

表 3 术前NLR与100例肝门胆管癌患者临床病理特征关系的多因素分析

影响因素	B	SE	Wald χ²	P值	OR(95%CI)
T分期	0.949	0.425	4.993	0.026	2.999(1.138~7.901)
肿瘤位置	0.894	0.425	4.420	0.032	0.346(0.131~0.911)

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表 4 术前PLR与100例肝门胆管癌患者临床病理征特征关系的多因素分析

影响因素	B	SE	Wald χ²	P值	OR(95%CI)
T分期	-1.137	0.447	6.466	0.007	3.635(1.416~9.333)
肿瘤大小	1.105	0.448	6.074	0.031	1.728(1.050~2.846)
淋巴结转移	0.158	0.442	0.127	0.721	1.171(0.493~2.783)

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