外周血粒淋比联合肿瘤相关中性粒细胞对术后胃癌患者预后的影响

摘要

Objective:To investigate the prognostic significance of preoperative neutrophil-lymphocyte ratio(NLR)combined with tu-mor-associated neutrophils(TANs)in the stroma of gastric cancer tissues of patients.Methods:One hundred and twenty-six gastric cancer tissue samples from patients enrolled in Changhai hospital from June 2006 to May 2011 were divided into four groups accord-ing to NLRs in preoperative peripheral blood combined with high or low infiltration of neutrophils in gastric cancer tissues.The 5-year survival of the four groups was then compared,and their correlations with clinicopathologic features and prognosis were analyzed.Re-sults:High NLRs in peripheral blood combined with low infiltrating TANs in gastric tissues was associated with lower differential grade (P<0.001)and larger tumor size(P=0.026).Of the four groups,patients with high NLR in peripheral blood combined with low infiltrat-ing TANs in gastric cancer tissues demonstrated the lowest survival rates,whereas those with low NLR and high infiltrating TANs had highest survival rates, and this difference was statistically significant (P<0.05). Univariate and multivariate Cox regression analyses showed that high NLR in peripheral blood combined with low infiltrating TANs in gastric cancer tissues(P<0.05)was an independent factor indicating poor prognosis.Conclusions:NLR in preoperative peripheral blood combined with infiltrating TANs in gastric cancer tissues can be used as a prognostic indicator for patients with gastric cancer,especially high NLR in preoperative peripheral blood com-bined with low infiltrating TANs in gastric cancer tissue indicates poor prognosis.%目的:探讨胃癌患者外周血中性粒细胞与淋巴细胞比值(neutrophil to lymphocyte ratio,NLR)和胃癌间质肿瘤相关中性粒细胞(tumor-associated neutrophils,TANs)对胃癌患者预后的预测价值.方法:选取第二军医大学附属长海医院2006年6月至2011年5月收治的126例胃癌患者,根据术前外周血NLR及胃癌患者TANs的浸润情况,将其分为4个组,比较全组胃癌患者的术后生存率,并分析其与临床病理学特征及预后的相关性.结果:NLR高合并TANs低浸润组肿瘤分化程度较低(P<0.001)且肿瘤体积较大(P=0.026).4个组中NLR高合并TANs低浸润组生存率最低,NLR低合并TANs高浸润组生存率最高,且差异具有统计学意义(P<0.05).单因素及多因素Cox回归分析均显示:NLR高合并TANs低浸润(P<0.05)是影响胃癌预后的独立危险因素.结论:术前外周血NLR联合胃癌组织中TANs浸润可作为判断胃癌患者预后的指标,且术前外周血NLR高联合胃癌组织中TANs低浸润胃癌患者的预后较差.