术前中性粒细胞/淋巴细胞比值与胃癌患者病理特征及其预后的相关性研究

Correlations between Preoperative Ratio of Neutrophil to Lymphocyte and Clinicopathological Features and Prognosis of Patients with Gastric Cancer

目的探讨术前中性粒细胞/淋巴细胞比值(NLR)与胃癌患者临床病理特征及其预后的相关性。方法选取2008年9月-2010年12月于我院行胃癌根治术的胃癌患者100例,收集患者的临床资料、病理学资料、影像学资料等,采外周血进行检测,计算术前NLR,对患者各项临床资料进行单因素分析,通过Cox回归模型探讨NLR与胃癌患者预后生存的关系。结果本组中不同性别、年龄、肿瘤大小和分化程度NLR比较差异无统计学意义(P>0.05);有淋巴结转移者NLR高于无淋巴结转移者,TNM分期越高NLR水平越高(P<0.05)。单因素分析显示,不同肿瘤大小、肿瘤分化程度、淋巴结转移、TNM分期、NLR胃癌患者5年生存率比较差异有统计学意义(P<0.01)。多因素Cox分析显示,分化程度(低分化)、TNM分期(Ⅲ期)、NLR(NLR≥3)为影响胃癌患者5年生存率的独立危险因素(P<0.001)。结论胃癌患者具有低分化、预后差等临床病理特征,术前NLR≥3是影响胃癌预后的独立危险因素。

Objective To investigate the relationships between the ratio of preoperative neutrophil to lymphocyte （NLR） and the clinicopathological features and prognosis of gastric cancer patients. Methods A total of 100 patients with gastric cancer admitted to our hospital between September 2008 and December 2010 were selected for analysis of their clinical, pathological, and imaging data. The peripheral blood of patients was detected and preoperative NLR was calculated. The clinical data of patients were analyzed by univariate analysis while the relationship between NLR and prognosis of patients with gastric cancer was ana- lyzed using the Cox regression model. Results There was no significant difference of NLR between patients of different gender, age, tumor size or tumor differentiation （P〉0. 05 ）. NLR in patients with lymph node metastasis was higher than that in patients without it, and it increased with TNM stage （P〈0.05） . Single factor analysis showed that the tumor size, tumor differentiation, lymph node metastasis,TNM stage and NLR affceted the 5 years＇ survival rate of patients with gastric cancer （P〈0.01）. Cox multiple factor analysis showed that the degree of differentiation （ poorly differentiated） and TNM stage （ stage Ⅲ） ,NLR （ NLR= 3） were independent risk factors for 5 years＇ survival rate of patients with gastric cancer（ P〈0.001 ）. Conclusion The clinical pathological features of gastric cancer patients are low differentiation and poor prognosis. Preoperative NLR is an independent risk factor for prognosis of gastric cancer. The prognosis of patients with gastric cancer tends to be poor when NLR exceeds 3.