Chi Po-Jui, Wu Kun-Ta, Chen Po-Jen, Chen Chung-Yen, Su Yu-Chieh, Yang Chung-Yi, Chen Jian-Han
Division of Nephrology, Department of Medicine, E-DA Hospital, Taiwan.
School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan.
Front Surg. 2022 Sep 6;9:939857. doi: 10.3389/fsurg.2022.939857. eCollection 2022.
This study aims to identify the pre- and postoperative changes in the neutrophil-lymphocyte ratio (NLR) and its correlations to clinical characteristics in obese patients who underwent laparoscopic sleeve gastrectomy (LSG).
Retrospectively, we included patients who has undergone LSG in our institution between January 2019 and April 2021. A total of 100 patients whose body mass index over 32.5 and received primary laparoscopic sleeve gastrectomy without infectious condition were included.
There was a significant decline in NLR (T0 vs. POM3 2.21 vs. 1.78, = 0.005), neutrophil (T0 vs. POM3 5369 vs. 4050, < 0.001) and lymphocyte count (T0 vs. POM3 2440: 2100, < 0.001, respectively) at postoperative 3 months (POM3) compared to preoperative (T0) levels, but similar between POM3 and POM6. The declined counts (Neutrophile vs. Lymphocyte 1445.5/µl vs. 323.5/µl, < 0.001) and percentage (Neutrophile vs. Lymphocyte 25.11% vs. 13.07%, < 0.001) of neutrophile are higher than lymphocyte from T0 to POM3, but similar in POM3 and POM6. Preoperative NLR has a significant correlation with the preoperative body weight, preoperative insulin level, and excessive body weight loss (EBWL) at POM3. Preoperative NLR <2.36 had a sensitivity of 67.6% and a specificity of 62.5% in predicting successful weight loss (EBWL > 37.7%) at POM3 (AUC = 0.635, = 0.032).
There was a significant decline in NLR, neutrophil, and lymphocyte count from T0 to POM3, but similar between POM3 and POM6. The declined counts and percentage of neutrophile are higher than lymphocyte. Preoperative NLR shows the potential to be used as a prognostic biomarker for predicting successful weight loss at POM3 after LSG. Further studies could be designed to evaluate the value of prediction in successful outcome after LSG and figure out the relationship between the changes of neutrophil function and oncogenesis.
本研究旨在确定接受腹腔镜袖状胃切除术（LSG）的肥胖患者术前和术后中性粒细胞与淋巴细胞比值（NLR）的变化及其与临床特征的相关性。
我们回顾性纳入了2019年1月至2021年4月在我院接受LSG的患者。共纳入100例体重指数超过32.5且接受初次腹腔镜袖状胃切除术且无感染情况的患者。
与术前（T0）水平相比，术后3个月（POM3）时NLR（T0 vs. POM3 2.21 vs. 1.78，P = 0.005）、中性粒细胞（T0 vs. POM3 5369 vs. 4050，P < 0.001）和淋巴细胞计数（T0 vs. POM3 2440 : 2100，P < 0.001）均显著下降，但POM3和POM6时相似。从T0到POM3，中性粒细胞计数下降（中性粒细胞 vs. 淋巴细胞 1445.5/µl vs. 323.5/µl，P < 0.001）和百分比下降（中性粒细胞 vs. 淋巴细胞 25.11% vs. 13.07%，P < 0.001）均高于淋巴细胞，但POM3和POM6时相似。术前NLR与术前体重、术前胰岛素水平以及POM3时的超重体重减轻（EBWL）显著相关。术前NLR < 2.36在预测POM3时成功减重（EBWL > 37.7%）方面的敏感性为67.6%，特异性为62.5%（AUC = 0.635，P = 0.032）。
从T0到POM3，NLR、中性粒细胞和淋巴细胞计数显著下降，但POM3和POM6时相似。中性粒细胞计数和百分比下降高于淋巴细胞。术前NLR显示出有可能作为预测LSG术后POM3时成功减重的预后生物标志物。可设计进一步研究来评估LSG术后成功结局的预测价值，并弄清楚中性粒细胞功能变化与肿瘤发生之间的关系。
