术前中性粒细胞与淋巴细胞比值对胃肠道间质瘤患者预后的预测价值

Prognostic value of preoperative neutrophii lymphocyte ratio in patients with gastrointestinal stromal tumors

目的探讨术前外周血中性粒细胞与淋巴细胞比值（neutrophil-lymphocyte ratio，NLR）对胃肠道间质瘤患者预后的预测价值。方法回顾性分析2009年6月至2013年12月期间温州医科大学附属第二医院收治并经手术治疗的79例GIST患者的临床病理资料。根据患者术前外周血中性粒细胞和淋巴细胞计数计算NLR值。根据NLR的ROC曲线，将患者分为低NLR（〈2．30）组和高NLR（≥2．30）组，比较两组患者的临床病理特征和术后5年无瘤生存率情况。结果低NLR组与高NLR组在肿瘤大小和危险度方面相比差异有统计学意义（χ2=9．517、12．411，均P〈0．05）。单因素分析结果显示，低NLR组和高NLR组的5年无瘤生存率分别为78％和32％，差异有统计学意义（x2=18．749，P=0．000）。多因素分析结果显示，高NLR是影响胃肠道间质瘤患者预后的独立危险因素（RR：3．516，95％ CI：1．453—8．506，P=0．005）。结论高NLR是胃肠道间质瘤患者预后的独立危险因素。

Objective To investigate the prognostic value of preoperative neutrophil lymphocyte ratio （NLR） in patients with gastrointestinal stromal tumors （GIST）. Methods The clinical-pathological data from 85 GIST cases were collected from the Second Affiliated Hospital of Wenzhou Medical University and retrospectively analyzed from June 2009 to December 2013. According to the exclusion criteria, 79 cases were enrolled. Preoperative neutrophil and lymphocyte count was collected and NLR was calculated. According to the receiver operating characteristic （ROC） curve of NLR, GIST patients were divided into low NLR group （ NLR 〈 2. 30） and high NLR group （ NLR≥2. 30 ）. Clinic-pathological features and five year disease free survival （DFS） were compared between the two groups. Results There was a statistical significant difference in tumor size and tumor risk between high NLR group and low NLR group （ respectively, X2 = 9. 517,12. 411, all P 〈 0. 05 ）. Univariate analysis showed that the five year disease free survival rate of low NLR and high NLR group were 78% and 32% （X2 = 18.749, P = 0.000）. By multivariate analysis a high NLR was identified as an independent risk factor of poorer prognosis for patients with GISTs （RR：3. 516,95% CI： 1. 453 - 8. 506, P = 0. 005 ）. Conclusion A high preoperative NLR is an independent risk factor for the prognosis of GISTs.