Borazan Ersin, Balık Ahmet Abdulhalik, Bozdağ Zehra, Arık Muhammed Kasım, Aytekin Alper, Yılmaz Latif, Elçi Muhsin, Başkonuş İlyas
Department of General Surgery, Gaziantep University School of Medicine, Gaziantep, Turkey.
Department of Pathology, Gaziantep University School of Medicine, Gaziantep, Turkey.
Turk J Surg. 2017 Sep 1;33(3):185-189. doi: 10.5152/turkjsurg.2017.3528. eCollection 2017.
Neutrophil-lymphocyte ratio still has a limited clinical use due to many non-cancer factors affecting neutrophils or lymphocytes in the present time. We aimed to evaluate the association between preoperative neutrophil-lymphocyte ratio and poor prognostic factors after curative elective colorectal surgery.
This clinical retrospective study was initiated with 95 patients, who had a curative surgical resection between 2003 and 2013. The patients were divided into two groups based on the preoperative neutrophil-lymphocyte ratio cut-off value above and below 3. The groups were compared for tumor localization, diameter, and staging; the histopathological perineural invasion; lymphovascular invasion; and overall survival. Univariate and multivariate Cox regression analyses were used to determine the role of neutrophil-lymphocyte ratio after stratification by several clinicopathological factors.
The mean age of patients was 59.79±1.48 (range, 23-90) years, and median follow-up period was 20.77±14.85 months. There was no significant difference in perineural or lymphovascular invasion, tumor size, stage, age, sex, and tumor location between the groups [Group 1 ratio >3 (n=52) and Group 2 ratio ≤3(n=43)]. Hemoglobin (p=0.035) and albumin levels (p=0.004) were lower in the Group 1. When the stage increased, differences between the rectal cancer groups were found. Overall survival was significantly lower in the Group 1 (p=0.013).
The study showed that a high neutrophil-lymphocyte ratio had an adverse effect on overall survival in colorectal cancer patients who had a curative surgery. However, we could not establish any association between neutrophil-lymphocyte ratio and the factors such lymphovascular invasion, perineural invasion, tumor size expect hemoglobin and serum albumin levels.
由于目前许多非癌症因素会影响中性粒细胞或淋巴细胞，中性粒细胞与淋巴细胞比值的临床应用仍然有限。我们旨在评估根治性择期结直肠手术后术前中性粒细胞与淋巴细胞比值与不良预后因素之间的关联。
本临床回顾性研究始于95例在2003年至2013年间接受根治性手术切除的患者。根据术前中性粒细胞与淋巴细胞比值的临界值3将患者分为两组。比较两组的肿瘤定位、直径和分期；组织病理学神经周围浸润；淋巴管浸润；以及总生存期。采用单因素和多因素Cox回归分析来确定在按几种临床病理因素分层后中性粒细胞与淋巴细胞比值的作用。
患者的平均年龄为59.79±1.48（范围23 - 90）岁，中位随访期为20.77±14.85个月。两组之间在神经周围或淋巴管浸润、肿瘤大小、分期、年龄、性别和肿瘤位置方面无显著差异[第1组比值>3（n = 52）和第2组比值≤3（n = 43）]。第1组的血红蛋白（p = 0.035）和白蛋白水平（p = 0.004）较低。当分期增加时，在直肠癌组之间发现了差异。第1组的总生存期显著较低（p = 0.013）。
该研究表明，高中性粒细胞与淋巴细胞比值对接受根治性手术的结直肠癌患者的总生存期有不利影响。然而，我们未能在中性粒细胞与淋巴细胞比值与诸如淋巴管浸润、神经周围浸润、肿瘤大小（除血红蛋白和血清白蛋白水平外）等因素之间建立任何关联。
