Department of Radiology, Shengjing Hospital of China Medical University, No. 36 Sanhao Street Heping District, Shenyang, 110004, Liaoning, China.
Med Oncol. 2014 Mar;31(3):855. doi: 10.1007/s12032-014-0855-1. Epub 2014 Jan 30.
The purpose of this study was to assess the value of the neutrophil-to-lymphocyte ratio (NLR) as a predictive factor for recurrence of colorectal liver metastases following radiofrequency ablation (RFA) treatment. We retrospectively analyzed clinical data from 98 patients who received routine RFA treatment for colorectal liver metastases. Univariate analyses were conducted to evaluate the effects of preoperative maximum tumor diameter, number of tumors, colon cancer staging, carcinoembryonic antigen levels, and preoperative and postoperative NLRs on disease-free survival (DFS). Statistically significant factors were further analyzed using multivariate Cox regression models to identify independent factors that were predictive of tumor recurrence. The one-, three-, and five-year DFS rates for patient were 66.3, 28.6, and 17.3%, respectively. Univariate analysis showed that preoperative NLR≥2.5 and postoperative increase in NLR were associated with decreased DFS rates. One-, three-, and five-year DFS rates for patients with preoperative NLR≥2.5 were 53.3, 20.0, and 11.1%, whereas patients with preoperative NLR<2.5 had DFS rates of 77.4, 35.8, and 22.6%, respectively (P=0.044). One-, three- and five-year DFS rates for patients with NLRs increased 1 month after RFA treatment were 52.3, 17.1, and 8.6%, while patients with no increased postoperative NLRs had DFS rates of 73.0, 34.9, and 22.2%, respectively (P=0.022). Cox regression analysis showed that postoperative NLR increase was an independent risk factor (P=0.029) for recurrence after RFA treatment in patients with colorectal liver metastases. The present study suggests that patients with preoperative NLRs≥2.5 or increased postoperative NLR are at an increased risk for recurrence after RFA treatment for colorectal liver metastases.
本研究旨在评估中性粒细胞与淋巴细胞比值（NLR）作为预测结直肠癌肝转移患者射频消融（RFA）治疗后复发的指标的价值。我们回顾性分析了 98 例接受常规 RFA 治疗的结直肠癌肝转移患者的临床资料。采用单因素分析评估术前最大肿瘤直径、肿瘤数量、结肠癌分期、癌胚抗原水平以及术前和术后 NLR 对无病生存率（DFS）的影响。进一步采用多因素 Cox 回归模型分析有统计学意义的因素，以确定预测肿瘤复发的独立因素。患者的 1 年、3 年和 5 年 DFS 率分别为 66.3%、28.6%和 17.3%。单因素分析显示，术前 NLR≥2.5 和术后 NLR 升高与 DFS 率降低有关。术前 NLR≥2.5 的患者 1 年、3 年和 5 年 DFS 率分别为 53.3%、20.0%和 11.1%，而术前 NLR<2.5 的患者 DFS 率分别为 77.4%、35.8%和 22.6%（P=0.044）。RFA 治疗后 1 个月 NLR 升高的患者 1 年、3 年和 5 年 DFS 率分别为 52.3%、17.1%和 8.6%，而术后 NLR 无升高的患者 DFS 率分别为 73.0%、34.9%和 22.2%（P=0.022）。Cox 回归分析显示，RFA 治疗后 NLR 升高是结直肠癌肝转移患者复发的独立危险因素（P=0.029）。本研究表明，术前 NLR≥2.5 或术后 NLR 升高的患者在接受 RFA 治疗后结直肠癌肝转移复发的风险增加。
