术前外周血NLR与PLR对胃癌预后的评估价值

摘要

Objective:To examine whether neutrophil/lymphocyte ratio (NLR) and platelet/lymphocyte ratio(PLR) have prognostic value in preoperative peripheral blood of patients undergoing gastric cancer resection.Methods:One hundred and fifty-four gastric cancer patients with complete clinical and pathological data were reviewed.The cutoff values were analyzed by ROC curve.The differences between groups were compared using chi-square test and U test.The Kaplan-Meier method was used to calculate the survival rate.The COX regression model was applied to analyze the independent prognostic risk factors,which may affect the survival rate.Results:One hundred and forty-two cases were followed up.The 1-year,3-year and 5-year survival rates were 75％,49％ and 32％,respectively.Tumor size (P=0.025),tumor differentiation type (P =0.021),depth of tumor invasion (P =0.007),lymph node staging (P＜0.001),lymph node metastasis rate (P＜0.001),TNM staging (P＜0.001),PLR (P＜0.001),NLR (P＜0.001) and surgical approach (P =0.013) were significantly correlated with survival rate by univariate analysis.Multivariate analysis showed that lymph node metastasis rate (P=0.004),TNM staging (P =0.005),PLR (P =0.001) could be independent risks factor for the prognosis of gastric cancer.Conclusion:PLR and NLR can be used to evaluate the prognosis of patients.PLR may be an independent risk factor for the overall survival rate.%目的:探讨术前外周血中性粒细胞与淋巴细胞计数比值(NLR)和血小板与淋巴细胞计数比值(PLR)对胃癌预后的评估价值.方法:收集154例具有完整临床病理资料的胃癌患者,采用ROC曲线分析cutoff值,x2检验、U检验比较不同分组之间的差异,Kaplan-Meier法计算生存率,COX回归模型多因素分析影响患者预后独立风险因素.结果:随访154例患者中失访患者12例,纳入生存分析的患者共142例,其中1年、3年、5年生存率分别为75％、49％、32％.单因素分析示:肿瘤大小(P=0.025)、分化类型(P=0.021)、浸润深度(P=0.007)、淋巴结分期(P＜0.001)、淋巴结转移率(P＜0.001)、TNM分期(P＜0.001)、PLR(P＜0.001)、NLR(P＜0.001)、手术方式(P=0.013)为影响胃癌患者预后的危险因素;多因素分析示:淋巴结转移率(P=0.004)、TNM分期(P=0.005)、PLR(P=0.001)可能为影响胃癌预后的独立危险因素.结论:PLR、NLR可以用来评价患者预后,PLR可能为影响预后总生存率的独立危险因素.