血清中性粒细胞/淋巴细胞比值与胃肠间质瘤患者预后的关系及其临床意义

Relation Between Blood Neutrophil-to-Lymphocyte Ratio and Prognostic of Patients with Gastrointestinal Stromal Tumor and Its Clinical Significance

目的检测中性粒细胞/淋巴细胞比值(NLR)在胃肠间质瘤(GIST)患者术前血清中的高低情况并分析其与预后的关系。方法采用回顾性的方法分析符合纳入条件的42例GIST患者术前3 d血常规中NLR及其病理切片中各免疫组织化学检测结果,并通过生存分析了解NLR与GIST患者预后的关系。结果 42例GIST患者中有22例NLR≥2.5(高NLR组),20例NLR<2.5(低NLR组)。NLR与GIST患者临床病理特征中核分裂像(χ2=9.45,P=0.002)和肿瘤大小有关(P=0.041)。高NLR组的GIST患者的3年生存率明显低于低NLR组的患者,其差异有统计学意义(χ2=5.44,P=0.022)。单因素分析结果显示,NLR、核分裂像及肿瘤大小与患者3年生存率有关(P<0.05);多因素分析结果显示,NLR和核分裂像是GIST患者3年生存率的独立危险因素(P=0.018,P=0.000)。结论 NLR和细胞核分裂像是影响GIST患者预后的独立危险因素,其对GIST患者的预后有一定预测价值。

Objective To investigate preoperative blood neutrophil-to-lymphocyte ratio（NLR）in patients with gastrointestinal stromal tumor（GIST）and analyze the relationship of the NLR to prognosis.Methods The data of NLR of peripheral blood samples on 3 d before surgery and the results of immunohistochemistry of 42 patients with GIST were analyzed respectively,the relation between the NLR and the prognosis of patients with GIST was understood by the survival analysis.Results The patients with high NLR（NLR≥2.5）was found in 22 cases,low NLR（NLR2.5）in 20 cases.The NLR was related to mitotic figures（χ 2 =9.45,P=0.002）and tumor size（P=0.041）.The 3-year survival rate of the patients with high NLR was shorter than that of the low NLR（χ 2 =5.44,P=0.022）.The 3-year survival rate was associated with NLR,mitotic figures,and tumor size（P0.05）in univariate analysis.The NLR and mitotic figures were independent prognostic indicators of 3-year survival（P=0.018,P=0.000）in Cox multivariate analysis.Conclusion Blood NLR and mitotic figures have some predictive value for the prognosis of patients with GIST.