中性粒细胞与淋巴细胞比例与胃癌转移淋巴结坏死的关系

Association between neutrophil to lymphocyte ratio and necrotic changes in metastatic lymph nodes of gastric cancer

目的研究胃癌患者术前中性粒细胞与淋巴细胞比例(neutrophil to lymphocyte ratio,NLR)与转移淋巴结坏死的关系。方法回顾分析我院2008-10至2010-10收治的92例行胃癌根治术,术后病理证实有淋巴结转移的胃癌患者,其中有转移淋巴结坏死50例,无转移淋巴结坏死42例。搜集术前血常规结果及其他临床资料,分析NLR对转移淋巴结坏死的影响。结果单因素分析显示,年龄、肿瘤直径、TNM分期、外周血淋巴细胞计数及NLR是影响胃癌转移淋巴结坏死的危险因素;多因素分析表明,年龄、外周血淋巴细胞计数及NLR是影响胃癌转移淋巴结坏死的独立因素。结论 NLR<3与胃癌转移淋巴结坏死程度有关,外周血淋巴细胞升高可能是造成胃癌转移淋巴结坏死的因素。

Objective To assess the association between preoperative neutrophil to lymphocyte ratio（NLR） and necrotic changes in metastatic lymph nodes of gastric cancer patients.Methods Ninety-two patients with gastric cancer who had undergone surgery in the General Hospital of Armed Police Forces from October 2008 to October 2010 were retrospectively analyzed.All the patients had confirmed gastric tumor with lymph nodes metastasis after the diagnostic slides were reviewed.Of these patients,50 had necrotic changes in metastatic lymph nodes while 42 did not.Laboratory analysis including preoperative blood count results and other clinical data were collected.Results As revealed by univariate analysis,age,tumor diameter,TNM classification,lymphocyte count（LC）,and neutrophil to lymphocyte ratio（NLR） were significantly correlated with necrotic changes in metastatic lymph nodes of gastric cancer.Multivariable analysis showed that age,LC and NLR were independent prognostic factors of necrotic changes in metastatic lymph nodes.Conclusions NLR〈3 has much effect on necrotic changes in metastatic lymph nodes of gastric cancer,and lymphocyte count（LC） may be a cause of necrotic changes in metastatic lymph nodes of gastric cancer.