术前外周血中性粒细胞与淋巴细胞比值在预测食管癌根治术后淋巴结转移中的临床价值

摘要

目的 探讨术前外周血中性粒细胞与淋巴细胞比值(NLR)在预测食管癌根治术后淋巴结转移中的临床价值.方法 回顾性分析我院2015年2月到2017年3月行食管癌根治术的110例食管癌患者的临床资料.以110例食管癌患者NLR≥4为临界点,将110例食管癌患者分为高NLR组(即NLR≥4)45例和低NLR组(即NLR<4)65例,比较2组患者临床特征、淋巴结转移率,并采用logistic回归分析食管癌根治术后淋巴结转移的影响因素.结果 本组110例患者共有87例患者出现淋巴结转移,其中高NLR组45例中有43例(95.56％)出现淋巴结转移,低NLR组65例中有44例(67.69％)出现淋巴结转移.高NLR组的淋巴结转移数及肿瘤浸润深度、远处转移均多于低NLR组(P<0.05),表明术前NLR水平和食管癌根治术后患者淋巴结转移有关.高NLR组的淋巴结转移人数比例、淋巴结转移度均高于低NLR组(P<0.05).肿瘤T分期[OR=1.898,95％CI(1.151～3.130)]、NLR≥4[OR=1.919,95％CI(1.076～3.422)]是食管癌患者淋巴结转移的发生的独立危险因素(P<0.05).结论 术前NLR较高的食管癌患者其淋巴结转移的风险性越大、肿瘤浸润越深、远处转移可能性越大,提示应扩大术中淋巴结清扫的范围.%Objective To investigate the clinical value of preoperative neutrophil to lymphocyte ratio in predicting lymph node metasta-sis after radical resection of esophageal carcinoma. Methods The clinical data of 110 patients with esophageal carcinoma who underwent radical resection of esophageal carcinoma from February 2015 to March 2017 in our hospital were retrospectively analyzed. NLR≥4 was the critical point,all patients were divided into high NLR group(NLR≥4) in 45 cases,the low NLR group(NLR<4) 65 cases,compared two groups of patients with clinical characteristics,lymph node metastasis,and regression analysis of factors influencing lymph node metastasis af-ter radical resection of esophageal carcinoma by logistic. Results There were 87 patients with lymph node metastasis in 110 cases,among which 43 cases(95. 56％) had lymph node metastasis in 45 cases of high NLR group,and 44 cases(67. 69％) had lymph node metastasis in 65 cases in low NLR group. The number of lymph node metastasis,depth of tumor invasion and distant metastasis in the high NLR group were higher than those in the low NLR group(P<0. 05),which indicated that the preoperative NLR level was related to lymph node metastasis af-ter radical resection of esophageal carcinoma. The number of lymph node metastasis and lymph node metastasis in the high NLR group were higher than those in the low NLR group(P<0. 05). The tumor T stage(OR=1. 898,95％CI:1. 151～3. 130),NLR≥4(OR=1. 919,95％CI:1. 076～3. 422) is the independent risk factors of lymph node metastasis in patients with esophageal cancer(P<0. 05). Conclusion The preoperative NLR was higher in patients with esophageal cancer and its lymph node metastasis,the greater the risk of distant metastasis tumor the deeper the infiltrating,it is more likely,to suggest it should expand the range of lymph node dissection in the operation,the lymph node metastasis,radical dissection has certain value.