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題名 | Can Pre-operative Neutrophil-lymphocyte Ratio Predict Microscopic Perforated Colon Cancer Outcome?=手術前嗜中性球與淋巴球的比率是否可以預測大腸癌破裂病患的預後 |
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作者姓名(中文) | 吳俊毅; 江支銘; 游正府; 唐瑞平; 陳進勛; 游耀東; 葉建裕; 謝寶秀; 蔡文司; 洪欣園; 蔣昇甫; 賴正洲; | 書刊名 | 中華民國大腸直腸外科醫學會雜誌 |
卷期 | 29:4 2018.12[民107.12] |
頁次 | 頁204-210 |
分類號 | 416.245 |
關鍵詞 | 大腸癌; 破裂; 嗜中性球與淋巴球比率; 存活率; Colon cancer; Perforation; Neutrophil-lymphocyte ratio; Survival; |
語文 | 英文(English) |
中文摘要 | 目的:目前研究顯示微觀的發炎環境與癌症的進程相關。嗜中性球與淋巴球的比率(NLR)在可切除的大腸直腸癌是一個已知重要的預測因子,但目前並沒有相關文章討論到大腸癌破裂的病人預後。方法:以回溯性研究的方法,根據病理報告挑選本院1995年至2015年顯微鏡下大腸癌破裂並接受手術之病患。排除條件為短期死亡(手術後30天內),瘜肉切除破裂,以及確診遠端轉移的病人。依照嗜中性球與淋巴球的比率(NLR)分為高低兩組(> 5或≤ 5)分別比較病患之臨床病理表現、長期整體存活率(OS)及無病存活率(DFS)。主要結果分析:存活分析。結果:在大腸破裂癌病患中,嗜中性球與淋巴球的比率較高的病患在統計上有顯著的傾象有:白血球增多(WBC > 12000/uL) (12.9% vs. 59.7%, p < 0.001)、較低的血液中白蛋白(albumin < 3.5 g/dL) (32.3% vs. 54.5%, p = 0.003)、緊急手術(5.4% vs. 26%, p < 0.001)。嗜中性球與淋巴球比率高低兩組間長期整體存活率(OS, p = 0.610)及無病存活率(DFS, p = 0.139)並無顯著差異。在本次研究中,對整體存活率及無病存活率的預測因子皆為病人年紀病人年紀大於65歲,血紅素小於10,以及淋巴結是否轉移(N stage)。限制:這是一個回朔性,非隨機的臨床研究。因為是單一中心的小樣本分析,也可能存在選樣偏差因為選樣偏差。結論:手術前嗜中性球與淋巴球比率對預測微觀下大腸癌破裂病人的存活率幫助有限。 |
英文摘要 | Purpose. Current studies showed inflammatory microenvironment associated with cancer progression. Neutrophil-to-lymphocyte ratio (NLR) is a known significant prognostic marker in resectable colorectal cancer patients; however, there is no research for perforated colon cancer patients. Method. We presented a retrospective study from our database of colorectal cancer research from 1995 to 2015. Microscopic-perforation colon cancer patients reviewed by pathology report were included. Exclusion criteria were short-term mortality (< 30 days mortality), post-polypectomy perforation and confirmed distal metastasis patient. Clinicopathological factors, long-term overall survival, disease-free survival were analyzed and compared between high (NLR > 5) and low (NLR ≤ 5) groups. Main outcome measures. The primary outcome was overall survival. Result. Comparing higher and lower neutrophil-to-lymphocyte ratio (NLR) groups in microscopic perforated colon cancer patients, the leukocytosis (WBC > 12000/uL) (12.9% vs. 59.7%, p < 0.001), lower serum albumin level (albumin < 3.5 g/dL) (32.3% vs. 54.5%, p = 0.003), and emergent operation rate (5.4% vs. 26%, p < 0.001) were significantly higher in higher NLR groups. However, long term overall survival rate (p = 0.610) and disease-free survival rate (p = 0.139) showed no significant difference between these two groups. The prognostic factors for overall survival and disease free survival in this study were patients aged > 65 years, Hb ≤ 10 g/dL, and N stage. Limitations. This is a retrospective, non-randomized study, and also limited by selection bias and small case number in a single institute. Conclusion. Neutrophil-to-lymphocyte ratio (NLR) has limited predictive value for outcome in microscopic perforation patients. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。