国际肿瘤学杂志

国际肿瘤学杂志 ›› 2022, Vol. 49 ›› Issue (8): 473-477.doi: 10.3760/cma.j.cn371439-20220610-00091

• 论著 • 上一篇    下一篇

AGR、PLR及NLR变化与转移性结直肠癌化疗疗效的相关性研究

赵莹1, 张革红2()   

  1. 1山西白求恩医院综合医疗科,太原 030032
    2山西医科大学第一医院肿瘤科,太原 030000
  • 收稿日期:2022-06-10 修回日期:2022-07-05 出版日期:2022-08-08 发布日期:2022-09-21
  • 通讯作者: 张革红 E-mail:lzl88666@163.com

Study on the correlations between AGR, PLR and NLR changes and chemotherapy efficacy of metastatic colorectal cancer

Zhao Ying1, Zhang Gehong2()   

  1. 1Department of Comprehensive Medicine, Shanxi Bethune Hospital, Taiyuan 030032, China
    2Department of Oncology, First Hospital of Shanxi Medical University, Taiyuan 030000, China
  • Received:2022-06-10 Revised:2022-07-05 Online:2022-08-08 Published:2022-09-21
  • Contact: Zhang Gehong E-mail:lzl88666@163.com

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摘要：

目的 探讨白蛋白-球蛋白比值（AGR）、血小板-淋巴细胞比值（PLR）、中性粒细胞-淋巴细胞比值（NLR）与转移性结直肠癌（mCRC）患者化疗疗效的相关性。方法 选取2016年1月至2020年 9月就诊于山西医科大学第一医院行化疗的107例mCRC患者的临床资料,收集化疗前及化疗3周期后AGR、NLR及PLR值进行回顾性分析;3周期后根据疗效评价将患者分为3组：部分缓解（PR）组、病情稳定（SD）组、疾病进展（PD）组,分析各组化疗前后AGR、PLR及NLR值的变化及变化程度与疗效的关系。结果 PR组18例,SD组53例,PD组36例,3组间年龄、性别、远处转移部位、肿瘤部位、T分期、N分期的差异均无统计学意义（F=0.33,P=0.721;χ2=2.94,P=0.230;χ2=2.34,P=0.674;χ2=0.80,P=0.669;χ2=5.68,P=0.224;χ2=2.06,P=0.375）。PR组患者化疗前AGR、PLR及NLR值分别为1.57±0.19、180.05±102.77、5.19（4.50,5.83）,化疗后分别为1.45±0.23、115.81±55.79、1.83（1.06,2.84）,差异均具有统计学意义（t=2.32,P=0.033;t=2.84,P=0.011;Z=-2.94,P=0.003）;SD组患者化疗前AGR、PLR及NLR值分别为1.66（1.40,1.77）、158.18（103.81,236.26）、2.41（1.75,4.07）,化疗后AGR、PLR及NLR值分别为1.35（1.15,1.60）、123.85（94.86,176.44）、1.49（1.27,2.33）,差异均具有统计学意义（Z=-4.51,P<0.001;Z=-3.31,P=0.001;Z=-3.90,P<0.001）;PD组患者化疗前AGR、PLR及NLR值分别为1.60（1.48,1.87）、122.07（77.14,175.72）、2.37（1.28,4.20）,化疗后AGR、PLR及NLR值分别为1.26（1.08,1.40）、176.39（139.89,280.64）、4.71（3.71,6.96）,差异均具有统计学意义（Z=-4.49,P<0.001;Z=-3.42,P=0.001;Z=-4.18,P<0.001）。化疗前后AGR差值（OR=3.66,95%CI为1.29~10.39,P=0.015）、PLR差值（OR=0.99,95%CI为0.99~1.00,P<0.001）及NLR差值（OR=0.59,95%CI为0.49~0.70,P<0.001）与临床疗效相关,AGR差值越大,近期疗效越差;PLR及NLR差值越大,近期疗效越好。治疗前后AGR、PLR及NLR的变化值与临床疗效的相关性由大到小排序为ΔNLR>ΔPLR>ΔAGR（r=-0.68,P<0.001;r=-0.51,P<0.001;r=0.25,P=0.009）。结论 化疗前后AGR、NLR、PLR水平变化与mCRC患者的近期疗效相关,对于患者疗效监测及治疗方案的进一步优选有一定意义。

关键词: 结直肠肿瘤, 白蛋白-球蛋白比值, 血小板-淋巴细胞比值, 中性粒细胞-淋巴细胞比值

Abstract:

Objective To investigate the correlations between albumin globulin ratio （AGR）, platelet lymphocyte ratio （PLR）, neutrophil lymphocyte ratio （NLR） and efficacy of chemotherapy for patients with metastatic colorectal cancer （mCRC）. Methods The clinical data of 107 mCRC patients who were treated at the First Hospital of Shanxi Medical University for chemotherapy from January 2016 to September 2020 were selected, and the values of AGR, NLR and PLR before chemotherapy and after 3 cycles of chemotherapy were collected for retrospective analysis. After 3 cycles, patients were divided into three groups according to efficacy evaluation： partial response （PR） group, stable disease （SD） group and progressive disease （PD） group. The changes of AGR, PLR and NLR values before and after chemotherapy, and the relationships between the degrees of changes and the therapeutic effects were analyzed. Results There were 18 cases in the PR group, 53 cases in the SD group and 36 cases in the PD group. There were no significant differences in age, sex, distant metastasis site, cancer site, T stage and N stage among the three groups （F=0.33, P=0.721; χ2=2.94, P=0.230; χ2=2.34, P=0.674; χ2=0.80, P=0.669; χ2=5.68, P=0.224; χ2=2.06, P=0.375）. The AGR, PLR and NLR values before chemotherapy in the PR group were 1.57±0.19, 180.05±102.77 and 5.19 （4.50, 5.83）, and they were 1.45±0.23, 115.81±55.79 and 1.83 （1.06, 2.84） after chemotherapy, with statistically significant differences （t=2.32, P=0.033; t=2.84, P=0.011; Z=-2.94, P=0.003）. In the SD group, AGR, PLR and NLR values before chemotherapy were 1.66 （1.40, 1.77）, 158.18 （103.81, 236.26）, 2.41 （1.75, 4.07）, and they were 1.35 （1.15,1.60）, 123.85 （94.86, 176.44）, 1.49 （1.27, 2.33） after chemotherapy, with statistically significant differences （Z=-4.51, P<0.001; Z=-3.31, P=0.001; Z=-3.90, P<0.001）. The AGR, PLR and NLR values in the PD group before chemotherapy were 1.60 （1.48, 1.87）, 122.07 （77.14, 175.72）, 2.37 （1.28, 4.20）, and they were 1.26 （1.08,1.40）, 176.39 （139.89, 280.64） and 4.71 （3.71, 6.96） after chemotherapy, with statistically significant differences （Z=-4.49, P<0.001; Z=-3.42, P=0.001; Z=-4.18, P<0.001）. The differences in AGR （OR=3.66, 95%CI： 1.29-10.39, P=0.015）, PLR （OR=0.99, 95%CI： 0.99-1.00, P<0.001） and NLR （OR=0.59, 95%CI： 0.49-0.70, P<0.001） before and after chemotherapy were related to clinical efficacy. The greater the difference of AGR, the worse the short-term efficacy. The greater the difference of PLR and NLR, the better the short-term efficacy. The correlation between the changes in AGR, PLR and NLR before and after treatment and the clinical efficacy was sorted in descending order ΔNLR>ΔPLR>ΔAGR （r=-0.68, P<0.001; r=-0.51, P<0.001; r=0.25, P=0.009）. Conclusion The changes in the levels of AGR, NLR and PLR before and after chemotherapy are correlated with the short-term efficacy of mCRC, and it has certain significance for monitoring the curative effects of patients and further optimizing the treatment plan.

Key words: Colorectal neoplasms, Albumin globulin ratio, Platelet lymphocyte ratio, Neutrophil lymphocyte ratio