目的 探讨中性粒细胞/ 淋巴细胞比值(NLR)、血小板/ 淋巴细胞比值(PLR)与原发性肝癌发生肌肉量减少的关系 及预测价值。 方法 通过回顾性研究纳入 2020 年 1 月至 2021 年 9 月于西南医科大学附属医院首诊为原发性肝癌患者,肌肉量 减少通过计算机断层扫描(CT)计算第三腰椎横截面骨骼肌指数( SMI) 判断。 通过 Logistic 回归分析肌肉量减少的危险因 素,根据受试者操作特征(ROC)曲线确定 NLR、PLR 最佳截止点,利用曲线下面积(AUC)评估各指标对原发性肝癌患者肌肉 量减少的预测效应。 结果 328 例原发性肝癌患者(男 269 例,女 59 例)中,总体肌肉量减少发生率为 61. 89%,ROC 曲线显示 NLR 与 PLR 最佳截止点分别为 4. 04 和 163. 01,AUC 值分别为 0. 629( 95% CI = 0. 569 ~ 0. 690,P< 0. 001)、0. 608( 95% CI = 0. 546~ 0. 670,P= 0. 001),NLR 联合 PLR 预测原发性肝癌肌肉量减少的 AUC 值为 0. 643,优于两者单独预测 AUC 值。 NLR 联 合 PLR 评分(0 分:NLR≤4. 04 且 PLR≤163. 01;1 分:NLR>4. 04 或 PLR>163. 01;2 分:NLR>4. 04 且 PLR>163. 01)能够进一步 分层原发性肝癌患者肌肉量减少情况,组间差异具有统计学意义(χ 2 = 24. 262,P<0. 001)。 结论 NLR、PLR 是原发性肝癌患者 发生肌肉量减少的独立预测因素,两者联合更易识别原发性肝癌发生肌肉量减少的患者。

Objective To investigate the relationship between neutrophil to lymphocyte ratio NLR platelet to lymphocyte ratio PLR and muscle mass loss in patients with primary liver cancer. Method 328 primary liver cancer patients were included in a retrospective study. Cross sectional skeletal muscle index SMI of the third lumbar vertebra was Computed with Computed Tomography CT . The risk factors of muscle loss were analyzed by Logistic regression and the optimal cut-off values of NLR and PLR were determined according to receiver operating characteristics ROC curve. The area under the curve AUC was used to evaluate the predictive effect of each indicator on muscle loss in primary liver cancer patients. Result 328 primary liver cancer patients included 269 male patients and 59 female patients and the incidence of total muscle mass loss was 61. 89%. ROC curve showed that the optimal cut-off values of NLR and PLR were 4. 04 and 163. 01 respectively and the AUC values were 0. 629 95%CI = 0. 569-0. 690 P < 0. 001 0. 608 95%CI = 0. 546- 0. 670 P = 0. 001 the AUC value of primary liver cancer muscle mass loss predicted by NLR combined with PLR was 0. 643 which was better than that predicted by NLR and PLR alone. NLR combined with PLR score 0 score NLR≤4. 04 and PLR≤163. 01 Score NLR > 4. 04 or PLR > 163. 01 2 scores NLR > 4. 04 and PLR > 163. 01 could further stratify the loss of muscle mass in primary liver cancer patients and the difference between groups was statistically significant χ2 = 24. 262 P < 0. 001 . Conclusions NLR and PLR are independent predictors of muscle mass loss in primary liver cancer patients and their combination is more likely to identify primary liver cancer patients with muscle mass loss.