本文選題：結(jié)腸癌 + 中性粒細胞淋巴細胞比率��； 參考：《廣西醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的:探討結(jié)腸癌患者術(shù)前中性粒細胞淋巴細胞比率(NLR)、血小板淋巴細胞比率(PLR)與淋巴結(jié)轉(zhuǎn)移的關(guān)系,指導(dǎo)結(jié)腸癌患者術(shù)中淋巴結(jié)清掃。方法:選取2016年1月至2016年12月于廣西醫(yī)科大學(xué)第一附屬醫(yī)院結(jié)直腸肛門外科行結(jié)腸癌切除術(shù)的患者239例做回顧性研究,其中男性137例(57.30%),女性102例(42.70%),平均年齡58.30歲(27歲~91歲)。收集患者術(shù)前白細胞計數(shù)、中性粒細胞計數(shù)、血小板計數(shù)、淋巴細胞計數(shù);收集患者術(shù)后病理信息,計算淋巴結(jié)轉(zhuǎn)移率、轉(zhuǎn)移度;繪制ROC曲線,通過最大約登指數(shù)確定NLR和PLR的臨界值;通過臨界值將病例分別分成高NLR組和低NLR組、高PLR組和低PLR組。分析術(shù)前NLR和PLR與臨床病理之間的相關(guān)性;單因素及多因素分析淋巴結(jié)轉(zhuǎn)移的相關(guān)因素。結(jié)果:1、根據(jù)ROC曲線,確定NLR、PLR的臨界值分別是1.99、144.43。2、術(shù)前高NLR、PLR組與腫瘤大體類型、腫瘤直徑、分化程度、組織分型、淋巴結(jié)分期、浸潤深度、TNM分期、脈管侵犯等顯著相關(guān);3.單因素中腫瘤大體類型、腫瘤直徑、分化程度、浸潤深度、脈管侵犯、NLR、PLR等與淋巴結(jié)轉(zhuǎn)移顯著相關(guān)。多因素分析中分化程度、浸潤深度、NLR、PLR是淋巴結(jié)轉(zhuǎn)移的獨立危險因素。結(jié)論:1、術(shù)前NLR、PLR的高低,可協(xié)助預(yù)測結(jié)腸癌患者淋巴結(jié)轉(zhuǎn)移的程度,提高對術(shù)前淋巴結(jié)分期判斷的準(zhǔn)確性。2、NLR、PLR是最簡明的生物學(xué)標(biāo)志物,臨床應(yīng)用經(jīng)濟、便捷、可操作性強�？煞从硻C體免疫功能和腫瘤進展?fàn)顟B(tài),術(shù)前NLR、PLR增高常提示腫瘤臨床分期晚。3、結(jié)腸癌患者術(shù)前NLR、PLR的高低,可指導(dǎo)結(jié)腸癌患者術(shù)中淋巴結(jié)清掃。4、NLR、PLR與結(jié)腸癌淋巴結(jié)轉(zhuǎn)移的相關(guān)性及其機制的知識可能對癌癥預(yù)防和治療有用。
[Abstract]:Objective: to investigate the relationship between preoperative neutrophil lymphocyte ratio (NLR), platelet lymphocyte ratio (PLR) and lymph node metastasis in patients with colon cancer. Methods: a retrospective study was conducted in 239 patients who underwent colorectal and anal resection in the first affiliated Hospital of Guangxi Medical University from January 2016 to December 2016. There were 137 males (57.30m) and 102 females (42.70m), with an average age of 58.30 years (58.30 years) and 27 years (91 years). Collect preoperative leukocyte count, neutrophil count, platelet count, lymphocyte count, collect postoperative pathological information, calculate lymph node metastasis rate, draw ROC curve, The critical values of NLR and PLR were determined by the maximum Jordan index, and the cases were divided into high NLR group and low NLR group, high PLR group and low PLR group respectively. To analyze the correlation between preoperative NLR and PLR and clinicopathology, univariate and multivariate analysis of the related factors of lymph node metastasis. Results: according to the ROC curve, the critical value of NLR PLR was 1.99144.43.2. There was significant correlation between the preoperative high NLRL PLR group and tumor gross type, tumor diameter, differentiation degree, histological type, lymph node stage, depth of invasion, TNM stage, vascular invasion and so on. Tumor gross type, tumor diameter, differentiation degree, depth of invasion and vascular invasion of NLR PLR were significantly correlated with lymph node metastasis. In multivariate analysis, the degree of differentiation and the depth of invasion were independent risk factors for lymph node metastasis. Conclusion the level of preoperative NLRR PLR may help to predict the degree of lymph node metastasis in patients with colon cancer, and improve the accuracy of preoperative lymph node staging. It is the most concise biological marker. It is economical, convenient and operable in clinical application. It can reflect the immune function and the progress of tumor. The increase of NLRL PLR before operation often indicates that the clinical stage of tumor is late. 3. The level of NLRL PLR in patients with colon cancer before operation is higher than that in patients with colon cancer. The knowledge of the correlation and mechanism between lymph node dissection and lymph node metastasis in colon cancer patients may be useful for cancer prevention and treatment.
【學(xué)位授予單位】：廣西醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R735.35

【參考文獻】

中國期刊全文數(shù)據(jù)庫 前5條

1 章志丹;張君嚴(yán);魯，

本文編號：2048605