目的 探讨术前中性粒细胞淋巴细胞比值(neutrophil lymphocyte ratio,NLR)对喉癌患者预后的影响.方法 回顾性分析2004年1月1日-2009年10月30日唐山市协和医院耳鼻咽喉头颈外科202例喉癌患者的临床资料,确定NLR最佳临界值,研究可能影响喉癌患者术后复发及5年生存率的相关因素中(年龄、性别、T分期、病理分化程度、淋巴结转移、肿瘤原发部位及NLR值)NLR是否为独立影响因素.分析NLR与喉癌患者颈部淋巴结转移的关系.结果 确定NLR的最佳临界值为2.85,将患者分为高NLR组(NLR≥2.85)与低NLR组(NLR＜2.85).经单因素及多因素分析,T分期、颈淋巴结转移情况、肿瘤原发部位、术前NLR高低是影响喉癌术后复发的独立因素.T分期、颈淋巴结转移情况是影响喉癌术后5年生存率的独立因素.NLR值的增高可以增加颈部淋巴结转移率.结论 术前NLR水平是喉癌患者术后复发和颈部淋巴结转移的影响因素,对喉癌患者预后的评估具有重要意义.%Objective To explore the effect of preoperative neutrophil lymphocyte ratio (NLR) on the prognosis of patients with laryngeal carcinoma.Methods Clinical data of 202 patients with laryngeal carcinoma treated from January 2004 to October 2009 were retrospective analyzed to determine the optimal critical value of NLR.To study whether NLR is an independent factor affecting the recurrence and 5-year survival rate of patients with laryngeal cancer after surgery,single factor and multivariate analyses were performed.The factors included age,gender,T stage,pathological differentiation,lymph node metastasis,primary tumor site and NLR value.The relationship between NLR and cervical lymph node metastasis was analyzed.Results The optimal critical value of NLR was 2.85,by which cases were divided into high NLR group (NLR≥2.85) and low NLR group (NLR ＜ 2.85).Single factor and multivariate analyses indicated that T staging,lymph node metastasis,primary tumor location,and NLR were the independent factors affecting the recurrence of laryngeal carcinoma.T stage and lymph node metastasis were the independent factors affecting 5-year survival rate of laryngeal carcinoma.The increase of NLR value increased the rate of cervical lymph node metastasis.Conclusion Preoperative NLR level influences the recurrence and cervical lymph node metastasis of laryngeal carcinoma and can be considered a prognosis factor of laryngeal cancer.
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