中性粒细胞/淋巴细胞、血小板/淋巴细胞与胃肠道间质瘤Fletcher分级的关系

Correlations of neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios with the Fletcher grading of gastrointestinal stromal tumors

目的：探讨中性粒细胞/淋巴细胞、血小板/淋巴细胞比值与胃肠道间质瘤Fletcher分级的关系。方法选取广东省第二人民医院2005年2月到2012年12月间明确为GIST的49例患者临床资料进行回顾性研究，分析中性粒细胞/淋巴细胞（NLR）、血小板/淋巴细胞（PLR）比值与肿瘤最大直径、核分裂相以及Fletcher分级的关系，对两个指标术前判断胃肠道间质瘤（GIST）危险度的价值进行评价。结果中性粒细胞/淋巴细胞（NLR）、血小板/淋巴细胞（PLR）比值与肿瘤直径和核分裂相密切相关，高NLR、PLR比值（NLR〉2.4，PLR〉132）预示更大的肿瘤直径和更高的核分裂相；与Fletcher分级吻合（P〈0.05），随着NLR或PLR的增大，Fletcher分级加重，GIST侵袭危险度上升。NLR、PLR在预测GIST侵袭危险度方面差异无统计学意义（P=0.445）。结论中性粒细胞/淋巴细胞（NLR）、血小板/淋巴细胞（PLR）比值与GIST肿瘤恶性指标和Fletcher分级密切相关，是一种临床上可行、有效的预测GIST恶性度的新指标。

Objective To determine the correlations of neutrophil-to-lymphocyte ratio（NLR）and platelet-to-lymphocyte ratio （PLR） with the Fletcher grading of gastrointestinal stromal tumors （GIST）. Methods Clinical data of 49 patients diagnosed with GIST from February 2005 to December 2012 at the Second Guangdong Provincial People’s Hospital were analyzed retrospectively. We evaluated the correlation of NLR and PLR with maximum tumor diameter,mitotic figures as well as the Fletcher grading. The application of these two parameters for predicting prognostic risk of GIST before surgery was also assessed. Results Significant correlations of NLR and PLR with clinicopathological features of GIST were confirmed , with the higher ratios （NLR〉2.4,PLR〉132） associating with larger tumor size and more mitotic figures. Also,the two parameters were positively correlated with Fletcher grading system（P〈0.05）,with higher NLR or PLR suggesting higher Fletcher grades and more invasiveness of GIST. No statistical significance was found between NLR and PLR in predicting prognostic risk of GIST（P=0.445）. Conclusion NLR and PLR correlate closely with malignant features and Fletcher grading system of GIST,and therefore can be considered as two feasible novel clinical parameters for predicting tumor prognostic risk.