The Importance of Systemic Inflammation Markers in the Survival of Patients with Complicated Colorectal Cancer, Operated in Emergency
The Importance of Systemic Inflammation Markers in the Survival of Patients with Complicated Colorectal Cancer, Operated in Emergency
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DOI：
10.21614/chirurgia.115.1.39
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发表时间：
2020-01-01
期刊：
影响因子：
0.6
通讯作者：
Constantinoiu, Silviu
中科院分区：
文献类型：
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作者：
Constantin, Georgiana Bianca;Firescu, Dorel;Constantinoiu, Silviu
引言：炎症反应在肿瘤发生中起着关键作用。最近有基于全身炎症反应的评分，如中性粒细胞/淋巴细胞比率（NLR）、血小板/淋巴细胞比率（PLR）、淋巴细胞/单核细胞比率（LMR），其已被证明在癌症患者中具有预后价值。这些评分允许识别对治疗反应差和生存期差的患者。本研究的目的是评估NLR，PLR，LMR和PNI在结直肠癌患者的长期生存方面的预后作用，在emergency.Material和Methods：我们纳入了391例患者入院并在外科II临床急诊县医院“Sf。AP.安德烈“从加拉蒂，2008年至2017年。我们分析了全身炎症NLR、PLR、MRL和PNI的临床旁因素。作为预后因素，分析生存曲线。高NLR和PLR值增加死亡风险（HR = 7.581，95%CI =（6.358，9.039），p值= 0.000000，分别为HR = 1.043，95%CI =（1.039，1.047），p值= 0.000000），LMR和PNI值的增加导致这种风险的降低（HR = 0.069，95%CI =（0.054.0.090），p值= 0.000000，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的增加（HR = 1.024，95% CI =（1.019.1.029），p值= 0.000000），对于LMR和PNI，死亡风险降低（HR = 0.353，95% CI =（0.248.0.504），p值= 0.000000，分别为HR = 0.852，95% CI =（0.822.0.883），p值= 0.000000）。单因素分析显示，NLR和PLR是生存的危险因素，LMR和PNI是生存的保护因素。多因素分析显示，PLR是独立的危险因素，LMR和PNI是独立的保护因素。
Introduction: 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 Methods: 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.Results: 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).Conclusions: 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.