PPI指数联合NLR LMR PLR预测晚期结直肠癌患者生存预后的价值分析

doi:10.3969/j.issn.1006-6233.2025.02.026

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摘要 目的: 探讨姑息预后指数(PPI)联合中性粒细胞与淋巴细胞比值(NLR)、淋巴细胞与单核细胞比值(LMR)、血小板与淋巴细胞比值(PLR)预测晚期结直肠癌(CRC)患者生存预后的价值。方法: 选取2019年6月至2023年6月晚期CRC患者117例,根据1年生存预后分为生存组(80例)与死亡组(37例),比较两组基线资料、PPI指数、NLR、LMR、PLR,分析PPI指数、NLR、LMR、PLR预测生存预后的价值。结果: 死亡组PPI指数、NLR、PLR高于生存组,LMR低于生存组(P<0.05);临床分期Ⅳ期患者PPI指数、NLR、PLR高于ⅢB期患者,LMR低于ⅢB期患者(P<0.05);浸润深度T3~T4患者PPI指数、NLR、PLR高于浸润深度T1~T2患者,LMR低于浸润深度T1~T2患者(P<0.05);低分化患者PPI指数、NLR、PLR高于中高分化患者,LMR低于中高分化患者(P<0.05);远处转移患者PPI指数、NLR、PLR高于无远处转移患者,LMR低于无远处转移患者(P<0.05);PPI指数、NLR、PLR与临床分期、浸润深度、远处转移呈正相关,与分化程度呈负相关,LMR与临床分期、浸润深度、远处转移呈负相关,与分化程度呈正相关(P<0.05);PPI指数、NLR、PLR是晚期CRC患者生存预后的独立危险因素,LMR是晚期CRC患者生存预后的独立保护因素(P<0.05);PPI指数、NLR、LMR、PLR预测晚期CRC患者生存预后的AUC分别为0.779、0.776、0.784、0.782,敏感度分别为70.27%、81.08%、75.68%、75.68%,特异度分别为71.25%、66.25%、73.75%、72.50%,联合预测晚期CRC患者生存预后的AUC为0.936,敏感度为83.78%,特异度为90.00%,联合预测价值显著高于各指标单独预测价值(P<0.05)。结论: PPI指数、NLR、LMR、PLR与晚期CRC患者临床病理特征密切相关,是生存预后的独立影响因素,联合预测价值较高。

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关键词 ：晚期结直肠癌, 姑息预后指数, 中性粒细胞与淋巴细胞比值, 淋巴细胞与单核细胞比值, 血小板与淋巴细胞比值, 生存预后

Abstract：Objective: To investigate the value of palliative prognosis index (PPI) combined with neutrophil to lymphocyte ratio (NLR), lymphocyte to monocyte ratio (LMR) and platelet-lymphocyte ratio (PLR) in predicting the survival prognosis of patients with advanced colorectal cancer (CRC). Methods: A total of 117 patients with advanced CRC from June 2019 to June 2023 were enrolled and divided into survival group (80 cases) and death group (37 cases) according to 1-year survival prognosis. Baseline data, PPI index, NLR, LMR and PLR of the two groups were compared to analyze the value of PPI index, NLR, LMR and PLR in predicting survival prognosis. Results: PPI index, NLR and PLR in death group were significantly higher than those in survival group, but LMR was significantly lower (P< 0.05). The significantly higher PPI index, NLR and PLR and lower LMR were found in patients in stage Ⅳ vs those in stage ⅢB, patients with infiltration depth T3 to T4 vs those with infiltration depth T1-T2, patients with low differentiation vs those with middle-high differentiation, and patients with distant metastasis vs those without distant metastasis(all P < 0.05). PPI index, NLR and PLR were positively correlated with clinical stage, depth of invasion and distant metastasis, but negatively correlated with differentiation degree. LMR was negatively correlated with clinical stage, depth of invasion and distant metastasis, while positively correlated with differentiation degree (P< 0.05). PPI index, NLR and PLR were independent risk factors for survival and prognosis of patients with advanced CRC, and LMR was a independent protective factor for survival and prognosis of patients with advanced CRC (P< 0.05). The AUC of PPI index, NLR, LMR and PLR in predicting survival and prognosis of patients with advanced CRC was 0.779, 0.776, 0.784 and 0.782, with the sensitivity of 70.27%, 81.08%, 75.68% and 75.68%, and the specificity of 71.25%, 66.25%, 73.75%, 72.50%, respectively. The AUC of combined prediction of survival prognosis in patients with advanced CRC was 0.936, with the sensitivity of 83.78 % and the specificity of 90.00 %, the combined prediction value was significantly higher than that of each index alone (P < 0.05). Conclusion: PPI index, NLR, LMR and PLR are closely related to clinicopathological features of patients with advanced CRC. They are independent factors influencing survival and prognosis, and their combined prediction value was is higher.

Key words： Advanced colorectal cancer Palliative prognosis index Neutrophil to lymphocyte ratio Lymphocyte to monocyte ratio Platelet to lymphocyte ratio Survival prognosis

基金资助:昆明市卫生健康委员会卫生科研课题项目,(编号:2022-03-10-008)

通讯作者: 罗煜

引用本文:

汤晓青, 郭玺, 万焱, 王洁, 徐斌, 陈瑾, 党富涛, 付海艳, 罗煜. PPI指数联合NLR LMR PLR预测晚期结直肠癌患者生存预后的价值分析[J]. 河北医学, 2025, 31(2): 320-326.
TANG Xiaoqing, GUO Xi, WAN Yan, et al. Value Analysis of Palliative Prognosis Index Combined with NLR LMR and PLR in Predicting Survival and Prognosis of Patients with Advanced Colorectal Cancer. HeBei Med, 2025, 31(2): 320-326.

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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2025.02.026 或 http://www.hbyxzzs.cn/CN/Y2025/V31/I2/320

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