腹腔镜外科杂志2025，Vol.30Issue(12)：895-900,6.DOI:10.13499/j.cnki.fqjwkzz.2025.12.895
系统性炎症与肝功能指标对腹腔镜肝癌根治术后死亡风险的预测价值
The predictive value of systemic inflammation and liver function indicators for the mortality risk after laparoscopic radical resection of liver cancer
摘要
Abstract
Objective:To explore the application value of preoperative neutrophil-to-lymphocyte ratio(NLR)and alanine ami-notransferase(ALT)/aspartate aminotransferase(AST)ratio in assessing mortality risk for patients undergoing laparoscopic radical re-section of primary liver cancer.Methods:A total of 220 patients with primary liver cancer who underwent laparoscopic radical resection from Mar.2021 to May 2024 were enrolled.According to the follow-up outcomes,they were divided into a mortality group and a survival group.Preoperative neutrophil and lymphocyte count,ALT and AST levels were measured to calculate NLR and ALT/AST.Risk factors influencing mortality after laparoscopic radical resection of primary liver cancer were screened.The predictive value of preoperative NLR and ALT/AST for mortality in patients undergoing laparoscopic radical resection of primary liver cancer was evaluated.Results:After a median postoperative follow-up of 30.6(range,12-45)months,14 patients were lost to follow-up,with a loss rate of 6.36%(14/220).Among the remaining 206 patients,72 died during the follow-up period,with a mortality rate of 34.95%(72/206).Clinical stage(Ⅲ),degree of differentiation(poor),tumor capsule(incomplete),NLR,and ALT/AST were identified as risk factors for mortality in patients with primary liver cancer after radical resection(P<0.05).The area under the curve of the combination of preoperative NLR and ALT/AST for predicting mortality in patients undergoing laparoscopic radical resection of primary liver cancer was 0.916,with a sensitivity of 87.50%and a specificity of 86.60%,all of which were higher than the individual predictive values of the above indicators(P<0.001).Conclusions:Preoperative NLR and ALT/AST are independent influencing factors for mortality after laparoscopic radical resection of primary liver cancer.Their combination enhances predictive efficacy which may aid in preoperative identification of high-risk patients and provide a basis for optimizing perioperative management.关键词
原发性肝肿瘤/肝癌根治术/腹腔镜检查/中性粒细胞与淋巴细胞比值/丙氨酸转氨酶与天冬氨酸转氨酶比值/死亡率/预测Key words
Primary liver neoplasms/Radical hepatectomy for liver cancer/Laparoscopy/Neutrophil to lymphocyte ratio/Ala-nine transaminase to aspartate transaminase ratio/Mortality/Forecasting分类
医药卫生引用本文复制引用
贾会文,徐赟,杨启,刘赟..系统性炎症与肝功能指标对腹腔镜肝癌根治术后死亡风险的预测价值[J].腹腔镜外科杂志,2025,30(12):895-900,6.基金项目
河南医学科技奖获奖项目(2024-YJ-169) （2024-YJ-169）
