| 摘要: |
| 目的 探讨中性粒细胞/淋巴细胞比值（NLR）联合C反应蛋白/白蛋白比值（CAR）对直肠癌术后吻合口瘘的预测价值。方法 回顾性分析2016年8月至2020年8月就诊于中国人民解放军总医院第一医学中心普通外科的187例直肠癌患者的临床资料，根据吻合口瘘发生与否分为吻合口瘘组（27例）和非吻合口瘘组（160例），比较两组在不同时间点的NLR、CAR差异。采用ROC曲线评价NLR、CAR及两者联合对直肠癌患者术后发生吻合口瘘的预测价值。采用多因素logistic回归分析直肠癌患者术后发生吻合口瘘的独立危险因素。结果 吻合口瘘组直肠癌患者的NLR在术后第3、5天均高于非吻合口瘘组（P＜0.05、P＜0.001），CAR在术后第5天高于非吻合口瘘组（P＜0.001）。ROC曲线分析显示，术后第5天的NLR联合CAR预测直肠癌患者术后发生吻合口瘘的AUC值为0.814，术后第3、5天NLR和术后第5天CAR单独预测吻合口瘘的AUC值分别为0.652、0.746和0.789，其中术后第5天NLR联合CAR的AUC值与术后第3天NLR的AUC值差异有统计学意义（P＝0.03）。多因素logistic回归分析显示，饮酒史、术后第3天NLR≥5.610、术后第5天NLR≥11.259和术后第5天CAR≥2.447是直肠癌患者术后发生吻合口瘘的独立危险因素（P均＜0.05）。结论 术后第5天NLR联合CAR、术后第3天NLR、术后第5天NLR和术后第5天CAR均对直肠癌术后吻合口瘘有预测价值，其中术后第5天NLR联合CAR预测效果最佳。 |
| 关键词: 中性粒细胞/淋巴细胞比值 C反应蛋白/白蛋白比值 直肠肿瘤 直肠切除术 吻合口瘘 |
| DOI：10.16781/j.CN31-2187/R.20211130 |
| 投稿时间：2021-11-08修订日期：2022-03-07 |
| 基金项目:国家自然科学基金（81871317）． |
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| Role of neutrophil to lymphocyte ratio combined with C reactive protein to albumin ratio in predicting postoperative anastomotic leakage in patients with rectal cancer |
| LIU Zhi-long1,2,DU Xiao-hui3* |
(1. Graduate School, Chinese PLA Medical School, Beijing 100853, China;
2. Department of General Surgery, Hainan Hospital, Chinese PLA General Hospital, Sanya 572000, Hainan, China;
3. Department of General Surgery, the First Medical Center, Chinese PLA General Hospital, Beijing 100853, China
*Corresponding author) |
| Abstract: |
| Objective To investigate the role of neutrophil to lymphocyte ratio (NLR) combined with C reactive protein to albumin ratio (CAR) in predicting postoperative anastomotic leakage (AL) in patients with rectal cancer. Methods The clinical data of 187 rectal cancer patients who underwent surgery in Department of General Surgery, the First Medical Center, Chinese PLA General Hospital from Aug. 2016 to Aug. 2020 were retrospectively analyzed. Patients were divided into AL group (27 cases) and non-AL group (160 cases), and NLR and CAR were compared between the 2 groups at different time points. Receiver operating characteristic (ROC) curve was used to evaluate the prediction value of NLR, CAR, and their combination for AL. Multivariate logistic regression analysis was used to explore the independent risk factors of postoperative AL in patients with rectal cancer. Results The NLR of rectal cancer patients in the AL group was significantly higher than that in the non-AL group on the 3rd day and 5th day after surgery (P<0.05 and P<0.001), and the CAR was significantly higher than that in the non-AL group on the 5th day after surgery (P<0.001). ROC curve analysis showed that the area under curve (AUC) value of NLR combined with CAR on the 5th day after surgery for predicting AL in rectal cancer patients was 0.814, and the AUC values of NLR on the 3rd day and 5th day after surgery and CAR on the 5th day after surgery were 0.652, 0.746 and 0.789, respectively. The AUC value of NLR combined with CAR on the 5th day after surgery was significantly higher than that of NLR on the 3rd day after surgery (P=0.03). Multivariate logistic regression analysis showed that drinking history, NLR ≥ 5.610 on the 3rd day after surgery, NLR ≥ 11.259 on the 5th day after surgery, and CAR ≥ 2.447 on the 5th day after surgery were independent risk factors for AL in rectal cancer patients (all P<0.05). Conclusion NLR combined with CAR on the 5th day after surgery, NLR on the 3rd day after surgery, NLR on the 5th day after surgery and CAR on the 5th day after surgery have predictive value for postoperative AL in rectal cancer patients, and NLR combined with CAR on the 5th day after surgery has the best predictive effect. |
| Key words: neutrophil to lymphocyte ratio C reactive protein to albumin ratio rectal neoplasms proctectomy anastomotic leakage |
