Combined use of preoperative lymphocyte counts and the post/preoperative lymphocyte count ratio as a prognostic marker of recurrence after curative resection of stage II colon cancer.
Combined use of preoperative lymphocyte counts and the post/preoperative lymphocyte count ratio as a prognostic marker of recurrence after curative resection of stage II colon cancer.
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DOI：
10.18632/oncotarget.23510
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发表时间：
2018-01-05
期刊：
影响因子：
--
通讯作者：
Uchida E
中科院分区：
文献类型：
--
作者：
Shinji S;Ueda Y;Yamada T;Koizumi M;Yokoyama Y;Takahashi G;Hotta M;Iwai T;Hara K;Takeda K;Okusa M;Kan H;Uchida E
结直肠癌复发的诊断标志物尚未建立。本研究的目的是确定 II 期结肠癌根治性手术后复发的新诊断标志物。在这项研究中，对 142 名在同一医疗中心接受手术治疗的局限性结肠癌患者的术前淋巴细胞计数和术后/术前淋巴细胞计数比 (PPLR) 的预后价值进行了评估。通过单变量和多变量分析检查患者人口统计学、血液化学和血清生化指标与无复发生存期（RFS）和癌症特异性生存期（CSS）的关联。受试者工作特征(ROC)曲线分析显示，RFS的淋巴细胞计数和PPLR的最佳截止值分别为1555.2/μl和1.151。单变量分析显示，肿瘤浸润深度、碳水化合物抗原 19-9 (CA19-9) 和术前低淋巴细胞计数 (≤1555.2/μl) 均与较差的 RFS 相关 (p < 0.05)。多变量分析显示，T4、低淋巴细胞计数和低 PPLR 是 RFS 不良的独立预测因素。此外，根据术前淋巴细胞计数高/低和 PPLR 高/低将患者分为四类。与其他患者相比，术前淋巴细胞计数低且 PPLR 低的患者的 RFS 和 CSS 最差。术前淋巴细胞计数和 PPLR 的组合似乎是预测 II 期结肠癌复发的潜在标志物。
Diagnostic markers for recurrence of colorectal cancer have not been established. The aim of the present study was to identify new diagnostic markers for recurrence after curative surgery of stage II colon cancer. In this study, the prognostic values of the preoperative lymphocyte count and the post/preoperative lymphocyte count ratio (PPLR) were evaluated in 142 patients with localized colon cancer treated with surgery at a single medical center. The associations of patient demographics, blood chemistry, and serum biochemical indices with recurrence-free survival (RFS) and cancer-specific survival (CSS) were examined by univariate and multivariate analyses. Receiver operating characteristic (ROC) curve analysis showed that the optimal cut-off values of the lymphocyte count and PPLR were, respectively, 1555.2/μl and 1.151 for RFS. On univariate analysis, tumor depth of invasion, carbohydrate antigen 19-9 (CA19-9), and preoperative low lymphocyte count (≤1555.2/μl) were all correlated with poorer RFS (p < 0.05). On multivariate analysis, T4, low lymphocyte count, and low PPLR were independent predictors of poor RFS. Furthermore, the patients were categorized into four categories based on preoperative lymphocyte count high/low and PPLR high/low. Patients with a low preoperative lymphocyte count and low PPLR had the poorest RFS and CSS compared to the other patients. The combination of the preoperative lymphocyte count and the PPLR appears to be a potential marker for predicting recurrence of stage II colon cancer.
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