胃癌患者术前NLR PLR RDW值与病理参数的关系

摘要

Objective:To assess the association between preoperative neutrophil–lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and red cell distribution width (RDW) and the tumor pathological features in gastric cancer (GC) patients. Methods: We re-viewed the records of 434 patients from 2012 to 2014 in Fujian Cancer Hospital. All patients were admitted to the hospital for the first time, and no patients received any cancer-specific pretreatment. For comparison, 309 age-and gender-matched healthy individuals who underwent annual physical examination at the hospital and 342 patients with chronic atrophic gastritis were enrolled. Results:GC patients had higher NLR, PLR, and RDW than the controls (P<0.000 1). Elevated NLR, PLR, and RDW were associated with the develop-ment of tumor stages as indicated by the Kruskal-Wallis analysis. However, no similar association was observed between the tumor dif-ferentiation grade and location and those three markers. Multivariate regression analysis further revealed that both NLR and PLR were independent predicting factors for either the tumor TNM or T stage (P<0.000 1). ROC curve analysis showed that NLR and PLR had a certain diagnostic effect on the preoperative T staging of GC. Conclusion:The preoperative NLR and PLR levels are closely correlated with the tumor TNM stages in GC patients. Both these parameters have potential values as markers to assist either in early diagnosis or preoperative tumor stage evaluation in GC.%目的：研究外周血中性粒细胞与淋巴细胞比值（neutrophil-to-lymphocyte ratio，NLR）、血小板与淋巴细胞比值（platelet-to-lymphocyte ratio，PLR）、红细胞分布宽度（red blood cell distribution width，RDW）与胃癌患者术后临床病理参数之间的关系。方法：回顾性分析福建省肿瘤医院2012年2月至2014年12月初诊入院手术的434例胃癌患者术前全血细胞计数及术后病理资料，同时选取年龄及性别匹配的342例慢性萎缩性胃炎患者及309例健康对照者进行对比分析。结果：胃癌组NLR、PLR和RDW的中位数值显著高于胃炎及正常对照组（P<0.0001）。Kruskal-Wallis相关分析显示患者NLR、PLR及RDW值随着病理分期的进展逐步升高（NLR、PLR：P<0.0001；RDW：P<0.05），但与肿瘤分化程度和肿瘤生长部位无显著相关。多因素回归分析结果表明NLR和PLR是肿瘤病理分期和T分期的独立相关因素（P<0.0001）。ROC曲线分析结果显示NLR和PLR对术前预判胃癌T分期有一定诊断疗效。结论：胃癌患者术前NLR及PLR值与胃癌TNM分期密切相关，可作为术前分期预判的非特异性标志物。