在接受结直肠癌治愈性手术的患者中,术前炎症状况与生存率之间的关系
Valerio Argiolas1, Simona Deidda1, Mirko Armas1
1Department of Surgical Science, University of Cagliari, Cagliari, Italy.
Surgical oncology
|November 22, 2025
概括
手术前的炎症和营养标志物,如血小板与淋巴细胞比率 (PLR) 和淋巴细胞与单细胞比率 (LMR) 独立预测结直肠癌患者的结果. 这些指数可以改善风险评估,超越传统的分阶段.
科学领域:
- 在瘤学瘤学.
- 免疫学 免疫学 免疫学
- 营养科学 营养科学
背景情况:
- 结肠直肠癌 (CRC) 构成了全球重大健康负担.
- 虽然TNM分期是标准的,但系统性炎症和营养状况会影响CRC的结果.
- 手术前的免疫营养指数需要对CRC的预后价值进行调查.
研究的目的:
- 评估手术前免疫营养指数的预后意义,在接受治疗切除的I-III期CRC患者中.
- 确定这些指数是否提供超越TNM分期的独立预测信息.
主要方法:
- 对616名CRC患者 (2013-2021) 的回顾性队列研究.
- 计算的术前指数:中性粒细胞与淋巴细胞的比率 (NLR),血小板与淋巴细胞的比率 (PLR),淋巴细胞与单细胞的比率 (LMR),全身免疫炎症指数 (SII),预后营养指数 (PNI) 和全身炎症评分 (SIS).
- 使用Kaplan-Meier和Cox模型分析了总生存率 (OS) 和无疾病生存率 (DFS).
主要成果:
- 所有测试的指数都显示了与OS和DFS的无变关联.
- 多变量分析确定PLR>176.9和LMR ≤3作为较差生存状况的独立预测因素.
- NLR > 2.95,PLR > 176.9,LMR ≤ 3,SII > 529.6,以及SIS 1-2独立预测了不良的DFS结果.
结论:
- 手术前的免疫营养指数作为非转移性结直肠癌的独立预后标志物.
- 将这些指数与TNM分阶段集成可以增强风险分层.
- 个性化治疗策略可能会从整合这些标记物中受益.
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