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预测结直肠癌患者长期预后的血细胞标志物。

Blood cell markers that can predict the long-term outcomes of patients with colorectal cancer.

机构信息

Department of Gastrointestinal Surgery, Japanese Red Cross Nagoya First Hospital, Michishita-cho, Nakamura-ku, Nagoya, Japan.

出版信息

PLoS One. 2019 Aug 1;14(8):e0220579. doi: 10.1371/journal.pone.0220579. eCollection 2019.

Abstract

OBJECTIVES

To identify blood cell markers that predict the long-term outcomes of patients with colorectal cancer.

METHODS

Data from 892 stage II and III colorectal cancer patients who underwent R0 resection were included. We analyzed the correlations of the preoperative blood data, previously reported prognostic indices, and clinicopathologic factors with the long-term outcomes, such as relapse-free survival and overall survival, using univariate and multivariate analyses.

RESULTS

Multivariate analysis showed that tumor location, stage, mean corpuscular volume, neutrophil-to-lymphocyte ratio, and lymphocyte-to- monocyte ratio were significantly correlated with relapse-free survival. A mean corpuscular volume ≥80.5 fL, neutrophil-to-lymphocyte ratio ≥5.5, and lymphocyte-to- monocyte ratio <3.4 had hazard ratios for disease relapse between 1.39 and 1.93. The cumulative scores of these three factors were aggregated into a laboratory prognostic score, with a maximum score at 6. The relapse-free survival and overall survival were well stratified by a laboratory prognostic score between 0-3 and 4-6, respectively, independent of the stage.

CONCLUSION

The mean corpuscular volume, neutrophil-to-lymphocyte ratio, and lymphocyte-to- monocyte ratio can serve as blood cell markers to predict the long-term outcomes of patients who underwent R0 resection for stage II/III colorectal cancer.

摘要

目的

鉴定预测结直肠癌患者长期预后的血细胞标志物。

方法

纳入 892 例接受 R0 切除术的 II 期和 III 期结直肠癌患者的数据。我们采用单因素和多因素分析,分析了术前血液数据、先前报道的预后指标以及临床病理因素与无复发生存和总生存等长期预后结果的相关性。

结果

多因素分析显示,肿瘤位置、分期、平均红细胞体积、中性粒细胞与淋巴细胞比值和淋巴细胞与单核细胞比值与无复发生存显著相关。平均红细胞体积≥80.5 fL、中性粒细胞与淋巴细胞比值≥5.5 和淋巴细胞与单核细胞比值<3.4 的疾病复发风险比为 1.39 至 1.93。这三个因素的累积评分被汇总为实验室预后评分,最高得分为 6 分。实验室预后评分在 0-3 分和 4-6 分之间对无复发生存和总生存进行了很好的分层,与分期无关。

结论

平均红细胞体积、中性粒细胞与淋巴细胞比值和淋巴细胞与单核细胞比值可作为血细胞标志物,用于预测接受 R0 切除术的 II/III 期结直肠癌患者的长期预后。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/99a4/6675058/5e29e6f2ec9f/pone.0220579.g001.jpg

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