摘要
目的探讨中性粒细胞/淋巴细胞比值(NLR)及肠道菌群分布与结直肠癌病情进展的关系及其对根治术后短期预后的预测效能。方法选取80例结直肠癌病患纳入结直肠癌组,同期选取40例结直肠良性息肉的病患纳入结直肠良性息肉组。收集术前血常规检测结果中性粒细胞计数及淋巴细胞计数资料,计算NLR。使用MicroScan微生物鉴定分析系统鉴定样本双歧杆菌、乳酸杆菌、肠球菌及大肠埃希菌并进行计数。分别按照疾病分期及预后情况将结直肠癌病患分组,分析NLR及肠道菌群分布与疾病进展及预后的相关性。结果与结直肠良性息肉组相比,结直肠癌组病患NLR显著升高,双歧杆菌及乳酸杆菌显著减少,肠球菌及大肠埃希菌显著增多(P<0.001)。与Ⅰ~Ⅱ期结直肠癌病患相比,Ⅲ期病患NLR显著升高,双歧杆菌及乳酸杆菌显著减少,肠球菌及大肠埃希菌显著增多(P<0.01);与预后良好组相比,预后不良组病患NLR显著升高,双歧杆菌及乳酸杆菌显著减少,肠球菌及大肠埃希菌显著增多(P<0.001)。ROC曲线分析结果显示NLR预测结直肠癌病患预后不良的曲线下面积(AUC)为0.752;肠道双歧杆菌、乳酸杆菌、肠球菌及大肠埃希菌预测结直肠癌病患预后不良的AUC分别为0.727,0.664,0.725及0.719;五者联合可将AUC提高到0.911。结论术前高水平的NLR及失衡的肠道菌群分布对结直肠癌病患根治术后预后不良具有较高的预测效能。
Objective To investigate the relationships between neutrophil-lymphocyte ratio(NLR)and intestinal flora distribution and the progression of colorectal cancer and their predictive efficacies in short-term prognosis after radical surgery.Methods A total of 80 patients with colorectal cancer were included in the colorectal cancer group,and 40 patients with colorectal benign polyps during the same period were included in the colorectal benign polyp group.The data of neutrophil count and lymphocyte count from preoperative routine blood test were collected and NLR was calculated.The samples of Bifidobacteria,Lactobacillus,Enterococcus,and Escherichia coli were identified and counted using MicroScan microbial identification and analysis system.Colorectal cancer patients were grouped according to disease stage or prognosis,and the correlations between NLR and intestinal flora distribution and disease progression and prognosis were analyzed.Results Compared with the colorectal benign polyp group,NLR was observably enhanced,Bifidobacteria and Lactobacillus were observably declined,and Enterococcus and Escherichia coli were observably enhanced in colorectal cancer group(P<0.001).Compared with stageⅠ~ⅡCRC patients,NLR was observably enhanced,Bifidobacteria and Lactobacillus were observably declined,and Enterococcus and Escherichia coli were observably enhanced in stageⅢpatients(P<0.01).Compared with the good prognosis group,NLR was observably enhanced,Bifidobacteria and Lactobacillus were observably declined,and Enterococcus and Escherichia coli were observably enhanced in the poor prognosis group(P<0.001).ROC curve analysis showed that the area under the curve(AUC)of NLR in predicting poor prognosis of colorectal cancer patients was 0.752.The AUC of intestinal Bifidobacteria,Lactobacillus,Enterococcus,and Escherichia coli for predicting poor prognosis of colorectal cancer patients were 0.727,0.664,0.725,and 0.719,respectively.The five combined raised the AUC to 0.911.Conclusion Preoperative high abundance of NLR and unbalanced intestinal flora distribution has high predictive efficacy for bad prognosis of patients with colorectal cancer after radical surgery.
作者
李腾飞
杨盈洲
刘春晖
LI Tengfei;YANG Yingzhou;LIU Chunhui(Pingmei Shenma Medical Group General Hospital,Pingdingshan,467000)
出处
《实用癌症杂志》
2025年第9期1472-1476,共5页
The Practical Journal of Cancer
关键词
结直肠癌
根治术
病情进展
预后
NLR
肠道菌群
Colorectal cancer
Radical operation
Disease progression
Prognosis
NLR
Intestinal flora
