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右半侧和左半侧 I-III 期结直肠腺癌的肿瘤学结局和炎症生物标志物的差异。

Differences in oncological outcomes and inflammatory biomarkers between right-sided and left-sided stage I-III colorectal adenocarcinoma.

机构信息

Department of Gastrointestinal Surgery, The First Affiliated Hospital of Shantou University Medical College, Shantou, China.

出版信息

J Clin Lab Anal. 2020 Apr;34(4):e23132. doi: 10.1002/jcla.23132. Epub 2019 Nov 21.

Abstract

BACKGROUND

The aim of this study was to investigate the differences in oncological outcome and inflammatory biomarkers between right-sided colon cancer (RCC) and left-sided colorectal cancer (LCRC).

METHODS

We retrospectively analyzed 339 patients with stage I-III colorectal cancer, including 125 RCC patients and 214 LCRC patients, who underwent radical resection from January 2012 to January 2014. Comparison of neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and lymphocyte-to-monocyte ratio (LMR) between RCC and LCRC was evaluated using the Mann-Whitney U test. Overall survival (OS) and disease-free survival (DFS) were analyzed using Kaplan-Meier analysis and compared using the log-rank test. Univariate and multivariate Cox regression analyses were used to identify the prognostic value of inflammatory markers.

RESULTS

Patients with RCC had higher NLR (P = .002) and PLR (P < .001) but lower LMR (P = .002) compared to LCRC. In stage I-III, RCC showed poorer OS and DFS than LCRC (61.6% vs 71.5%, P = .018; 64.8% vs 76.2%, P = .006). Univariate and multivariate analyses indicated that NLR, PLR, and LMR were independent predictors for both OS and DFS in RCC, whereas only PLR was found to be an independent prognostic predictor in LCRC.

CONCLUSION

The prognosis and prognostic value of inflammatory biomarkers were significantly different between RCC and LCRC. Novel therapeutic strategies are needed, and proper prognostic predictors should be selected according to colorectal tumor location.

摘要

背景

本研究旨在探讨右半结肠癌(RCC)和左半结直肠癌(LCRC)在肿瘤学结局和炎症生物标志物方面的差异。

方法

我们回顾性分析了 2012 年 1 月至 2014 年 1 月接受根治性切除术的 339 例 I-III 期结直肠癌患者,包括 125 例 RCC 患者和 214 例 LCRC 患者。采用 Mann-Whitney U 检验比较 RCC 和 LCRC 患者中性粒细胞与淋巴细胞比值(NLR)、血小板与淋巴细胞比值(PLR)和淋巴细胞与单核细胞比值(LMR)。采用 Kaplan-Meier 分析评估总生存期(OS)和无病生存期(DFS),并采用对数秩检验比较。采用单因素和多因素 Cox 回归分析评估炎症标志物的预后价值。

结果

与 LCRC 相比,RCC 患者的 NLR(P = 0.002)和 PLR(P < 0.001)更高,而 LMR 更低(P = 0.002)。在 I-III 期,RCC 的 OS 和 DFS 均较 LCRC 差(61.6% vs 71.5%,P = 0.018;64.8% vs 76.2%,P = 0.006)。单因素和多因素分析表明,NLR、PLR 和 LMR 是 RCC 患者 OS 和 DFS 的独立预测因素,而仅 PLR 是 LCRC 患者的独立预后预测因素。

结论

RCC 和 LCRC 之间的预后和炎症生物标志物的预后价值存在显著差异。需要新的治疗策略,并根据结直肠肿瘤位置选择合适的预后预测因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/60fe/7171299/fdacca8e049d/JCLA-34-e23132-g001.jpg

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