Constantin Georgiana Bianca, Firescu Dorel, Voicu Dragoş, Ștefănescu Bogdan, Serban Raul Mihailov Cristina, Panaitescu Eugenia, Bîrlă Rodica, Constantinoiu Silviu
Chirurgia (Bucur). 2020 Jan-Feb;115(1):39-49. doi: 10.21614/chirurgia.115.1.39.
The inflammatory response plays a critical role in carcinogenesis. There are recent scores based on the systemic inflammatory response, such as neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), lymphocyte/monocyte ratio (LMR), which have been shown to have prognostic value in cancer patients. These scores allow the identification of patients who will have poor response to treatment and poor survival. The aim of this study is to evaluate the prognostic role of NLR, PLR, LMR and PNI in terms of long-term survival in patients with colorectal cancer, operated in emergency. Material and We included 391 patients admitted and operated for complicated colorectal cancer in the Surgery II clinic of the Clinical Emergency County Hospital Sf. Ap. Andrei - from Galati, between 2008-2017. We analyzed the paraclinical factors of systemic inflammation NLR, PLR, MRL and PNI. As prognostic factors, survival curves were analyzed. The high values of NLR and PLR increased the risk of death (HR = 7.581, 95% CI = (6.358,9.039), p value = 0.000000, respectively HR = 1.043, 95% CI = (1.039, 1.047), p value = 0.000000), and the increased values of LMR and PNI led to the decrease of this risk (HR = 0.069, 95% CI = (0.054.0.090), p value = 0.000000, respectively HR = 0.758, 95 % CI = (0.730.0.788), p value = 0.000000). In the multivariate regression analysis, the increase of PLR resulted in an increase in the risk of death (HR = 1.024, 95% CI = (1.019.1.029), p value = 0.000000), and for the LMR and PNI, a reduction of the risk of death (HR = 0.353, 95% CI = (0.248.0.504), p value = 0.000000, respectively HR = 0.852, 95% CI = (0.822.0.883), p value = 0.000000). The univariate analysis showed that NLR and PLR are risk factors, and LMR and PNI are protective factors in terms of survival. The multivariate analysis revealed that PLR is an independent risk factor, and LMR and PNI were independent protection factors.
炎症反应在癌症发生过程中起关键作用。最近有基于全身炎症反应的评分，如中性粒细胞/淋巴细胞比值（NLR）、血小板/淋巴细胞比值（PLR）、淋巴细胞/单核细胞比值（LMR），已证明这些指标在癌症患者中具有预后价值。这些评分有助于识别对治疗反应不佳和生存期短的患者。本研究的目的是评估NLR、PLR、LMR和PNI对急诊手术的结直肠癌患者长期生存的预后作用。材料与方法：我们纳入了2008年至2017年间在加拉茨圣安德烈临床急救县医院第二外科病房收治并接受复杂结直肠癌手术的391例患者。我们分析了全身炎症反应的辅助临床因素NLR、PLR、MRL和PNI。作为预后因素，分析了生存曲线。NLR和PLR的高值增加了死亡风险（HR = 7.581，95%CI =（6.358，9.039），p值 = 0.000000，PLR分别为HR = 1.043，95%CI =（1.039，1.047），p值 = 0.000000），而LMR和PNI值的增加导致该风险降低（HR = 0.069，95%CI =（0.054，0.090），p值 = 0.000000，PNI分别为HR = 0.758，95%CI =（0.730，0.788），p值 = 0.000000）。在多因素回归分析中，PLR的增加导致死亡风险增加（HR = 1.024，95%CI =（1.019，1.029），p值 = 0.000000），而对于LMR和PNI，死亡风险降低（HR = 0.353，95%CI =（0.248，0.504），p值 = 0.000000，PNI分别为HR = 0.852，95%CI =（0.822，0.883），p值 = 0.000000）。单因素分析表明，就生存而言，NLR和PLR是危险因素，LMR和PNI是保护因素。多因素分析显示，PLR是独立危险因素，LMR和PNI是独立保护因素。
