NLR、FIB 和Pgp1 评估结直肠癌预后的价值

Value of NLR, FIB and Pgp1 in assessing prognosis of colorectal carcinoma

摘要:

目的 探讨中性粒细胞与淋巴细胞比值（NLR）、纤维蛋白原（FIB）和癌组织P- 糖蛋白1（Pgp1） 对结直肠癌预后的临床价值。方法 选取陕西省宝鸡市中心医院进行结直肠癌根治性切除术的223 例患者作 为研究对象，均为经AJCC 第七版肿瘤分期指南诊断的Ⅰ期或Ⅱ期的结直肠癌患者，且均术后留取癌组织病 理标本，随访5 年。以是否发生终点事件为标准，将患者分为预后良好组与预后不良组，分别统计NLR、FIB 和Pgp1 评估结直肠癌预后的敏感性和特异性。结果 多因素Cox 回归显示病理类型、术前肠梗阻、术后并 发症、Pgp1、NLR 及FIB 是影响结直肠癌预后的独立影响因素（P <0.05）；NIR 联合FIB 的AUC 面积相对 最高。NLR 联合FIB 可提高结直肠癌预后的敏感性和特异性，分别为78% 和79%。结论 NLR 联合FIB 预 测结直肠癌预后的敏感性高于3 者单独检测，临床上可先通过联合检测提高结直肠癌患者预后的准确性，及 时制定精准的医疗方案从而改善患者预后。

Abstract:

Objective To investigate the clinical value of P-glycoprotein 1 (Pgp1) expression, neutrophil to lymphocyte ratio (NLR) and fibrinogen (FIB) concentration in predicting the prognosis of colorectal carcinoma. Methods A total of 223 patients, who underwent radical resection of colorectal carcinoma in our hospital were involved as the research objects. All patients were diagnosed with stage I or II colorectal carcinoma according to the Seventh Edition AJCC Cancer Staging Manual. After operation cancer pathological specimens were collected from all patients, and these patients were followed up for 5 years. The patients were divided into a good prognosis group and a poor prognosis group according to the endpoint of follow-up. The prognostic sensitivity and specificity of Pgp1, NLR, FIB and the combination of Pgp1, NLR and FIB were evaluated. Results Pathological type, intestine obstruction before surgery, complications after surgery, Pgp1 expression, NLR and FIB were the independent risk factors influencing prognosis of colorectal cancer (P < 0.05). The ROC analysis showed that the AUC of NLR, FIB, and the combination of NLR and FIB were 0.801, 0.678 and 0.856, respectively. The AUC of the combination of NLR and FIB was the largest. The combined detection of NLR and FIB could improve the sensitivity (78%) and specificity (79%) of predicting the prognosis of colorectal carcinoma. Conclusions The sensitivity of combined NLR and FIB in predicting the prognosis of colorectal carcinoma is higher than the individual sensitivity of Pgp1, NLR and FIB alone. Furthermore, the combined detection of NLR and FIB can improve the accuracy of prognosis prediction for the patients with colorectal carcinoma, allowing for the timely development of accurate medical programs to improve the prognosis of the patients.