Liu Y J, Gao C Q, Wang G C, Wang Y C, Lu X Z, Han G S
Department of General Surgery, Affiliated Tumor Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou 450008, China.
Zhonghua Zhong Liu Za Zhi. 2020 Jan 23;42(1):70-73. doi: 10.3760/cma.j.issn.0253-3766.2020.01.011.
To assess the clinical value of neutrophil-to-lymphocyte ratio (NLR) in predicting anastomotic leak of postoperative rectal cancer patients. The clinical data of 787 rectal cancer patients who underwent anterior resection from January 2014 to December 2017 in Affiliated Tumor Hospital of Zhengzhou University were collected. The postoperative numbers of white blood cell (WBS) on postoperative day (POD)1, 3 and 5 were detected, and the NLR was calculated. The relationship of NLR and the incidence of anastomotic leak was analyzed, and the area under the receiver-operating characteristic (ROC) curves was calculated. The accuracy of postoperative NLR in predicting the incidence of anastomotic leak was evaluated. WBC counts of patients with leak on POD1, POD3 and POD5 were 13.2×10(9)/L, 9.1×10(9)/L and 8.9×10(9)/L, respectively, while those of patients without leak were 12.9×10(9)/L, 9.0×10(9)/L and 8.8×10(9)/L. The WBC count was not significantly different between patients with or without leak (>0.05). The average NLR values of patients with or without leak were 13.3 and 11.6 on POD1, 10.9 and 7.6 on POD3, 9.3 and 5.3 on POD5, respectively. The NLR values of patients with leak on POD3 and POD5 were significantly higher than those of patients without leak (<0.05). The cutoff value of NLR on POD3 was 8.6, the sensitivity and specificity of detecting the leakage was 73.2% and 75.6%, respectively, and the area under curve (AUC) was 0.744. The cutoff value of NLR on POD5 was 5.5, the sensitivity and specificity was 69.6% and 75.5%, the AUC was 0.726. The multivariate analysis result showed that NLR >8.6 was an independent factor for anastomotic leak prediction. Postoperative NLR on day 3 is useful in predicting anastomotic leak and can decrease the incidence of complication in rectal cancer patients who underwent anterior resection.
评估中性粒细胞与淋巴细胞比值（NLR）在预测直肠癌患者术后吻合口漏方面的临床价值。收集了2014年1月至2017年12月在郑州大学附属肿瘤医院接受前切除术的787例直肠癌患者的临床资料。检测术后第1、3和5天的白细胞（WBC）数量，并计算NLR。分析NLR与吻合口漏发生率的关系，并计算受试者工作特征（ROC）曲线下面积。评估术后NLR预测吻合口漏发生率的准确性。吻合口漏患者在术后第1、3和5天的白细胞计数分别为13.2×10⁹/L、9.1×10⁹/L和8.9×10⁹/L，而无吻合口漏患者的白细胞计数分别为12.9×10⁹/L、9.0×10⁹/L和8.8×10⁹/L。有或无吻合口漏患者的白细胞计数无显著差异（>0.05）。有或无吻合口漏患者在术后第1天的平均NLR值分别为13.3和11.6，术后第3天分别为10.9和7.6，术后第5天分别为9.3和5.3。术后第3天和第5天吻合口漏患者的NLR值显著高于无吻合口漏患者（<0.05）。术后第3天NLR的截断值为8.6，检测吻合口漏的灵敏度和特异度分别为73.2%和75.6%，曲线下面积（AUC）为0.744。术后第5天NLR的截断值为5.5，灵敏度和特异度分别为69.
