D-二聚体与淋巴细胞比值可作为结直肠癌伴肝转移患者的潜在预测和预后价值。

D-dimer to lymphocyte ratio can serve as a potential predictive and prognostic value in colorectal cancer patients with liver metastases.

机构信息

Department of Hepatobiliary Surgery, Guangxi Medical University Cancer Hospital, Guangxi Zhuang Autonomous Region, Nanning, 530021, People's Republic of China.

Guangxi Clinical Research Center for Colorectal Cancer, Guangxi Zhuang Autonomous Region, Nanning, 530021, People's Republic of China.

出版信息

BMC Surg. 2023 Mar 25;23(1):64. doi: 10.1186/s12893-023-01958-z.

DOI:10.1186/s12893-023-01958-z

PMID:36966285

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10040125/

Abstract

BACKGROUND

The intent of this research was to generate and investigate the D-dimer to lymphocyte ratio (DLR) capacity to forecast the risk and prognosis of colorectal cancer liver metastases (CRCLM).

METHODS

From January 2010 to December 2019, 177 clinicopathologically confirmed colorectal cancer (CRC) patients (89 in the control group and 88 in the experimental group) were identified at the Affiliated Cancer Hospital of Guangxi Medical University. Multivariate Cox regression analysis was used to screen independent predictive diagnostic and prognostic factors of liver metastasis in CRC, and receiver operating characteristic (ROC) curves and Kaplan‒Meier (K‒M) curves were established to analyze the diagnostic and predictive prognostic efficacy of the DLR in the development of CRCLM.

RESULTS

Patients with CRCLM had higher DLR levels and D-dimer levels in their blood, with statistically significant differences (p < 0.001). DLR might be employed as a predictor for the development of CRCLM, according to ROC curve research (sensitivity 0.670, specificity 0.775, area under the curve 0.765). D-dimer, lymphocyte count CEA, CA125, and CA199 were not linked to prognosis in patients with CRCLM in Cox regression analysis of dichotomous variables. In contrast, DLR level was a possible risk factor for the prognosis of patients with CRCLM (HR = 2.108, p = 0.047), and age, T stage, and DLR level (DLR < 0.4) were connected with the prognosis of patients with CRCLM (p < 0.05).

CONCLUSION

DLR serves as a risk indicator for the development of CRCLM.

摘要

背景

本研究旨在探讨 D-二聚体与淋巴细胞比值（DLR）对预测结直肠癌肝转移（CRCLM）风险和预后的能力。

方法

回顾性分析 2010 年 1 月至 2019 年 12 月广西医科大学附属肿瘤医院收治的 177 例经病理证实的结直肠癌（CRC）患者的临床病理资料，其中 89 例为对照组，88 例为试验组。采用多因素 Cox 回归分析筛选 CRC 肝转移的独立预测诊断和预后因素，建立受试者工作特征（ROC）曲线和 Kaplan-Meier（K-M）曲线分析 DLR 对 CRCLM 发生的诊断和预测预后效能。

结果

CRCLM 患者的 DLR 水平和血 D-二聚体水平均较高，差异有统计学意义（p<0.001）。ROC 曲线研究显示，DLR 可能作为 CRCLM 发生的预测指标（灵敏度 0.670，特异度 0.775，曲线下面积 0.765）。在二分类变量的 Cox 回归分析中，D-二聚体、淋巴细胞计数、CEA、CA125、CA199 与 CRCLM 患者的预后无关。相反，DLR 水平是 CRCLM 患者预后的可能危险因素（HR=2.108，p=0.047），年龄、T 分期和 DLR 水平（DLR<0.4）与 CRCLM 患者的预后有关（p<0.05）。