术前外周血NLR与PLR对胃癌预后的评估价值

Evaluation value of preoperative peripheral blood NLR and PLR on prognosis of gastric cancer

目的:探讨术前外周血中性粒细胞与淋巴细胞计数比值(NLR)和血小板与淋巴细胞计数比值(PLR)对胃癌预后的评估价值。方法:收集154例具有完整临床病理资料的胃癌患者,采用ROC曲线分析cutoff值,χ~2检验、U检验比较不同分组之间的差异,Kaplan-Meier法计算生存率,COX回归模型多因素分析影响患者预后独立风险因素。结果:随访154例患者中失访患者12例,纳入生存分析的患者共142例,其中1年、3年、5年生存率分别为75%、49%、32%。单因素分析示:肿瘤大小(P=0.025)、分化类型(P=0.021)、浸润深度(P=0.007)、淋巴结分期(P<0.001)、淋巴结转移率(P<0.001)、TNM分期(P<0.001)、PLR(P<0.001)、NLR(P<0.001)、手术方式(P=0.013)为影响胃癌患者预后的危险因素;多因素分析示:淋巴结转移率(P=0.004)、TNM分期(P=0.005)、PLR(P=0.001)可能为影响胃癌预后的独立危险因素。结论:PLR、NLR可以用来评价患者预后,PLR可能为影响预后总生存率的独立危险因素。

Objective： To examine whether neutrophil/lymphocyte ratio（NLR） and platelet/lymphocyte ratio（PLR） have prognostic value in preoperative peripheral blood of patients undergoing gastric cancer resection. Methods：One hundred and fifty-four gastric cancer patients with complete clinical and pathological data were reviewed. The cutoff values were analyzed by ROC curve.The differences between groups were compared using chi-square test and U test. The Kaplan-Meier method was used to calculate the survival rate. The COX regression model was applied to analyze the independent prognostic risk factors, which may affect the survival rate. Results：One hundred and forty-two cases were followed up.The 1-year, 3-year and 5-year survival rates were 75%, 49% and 32%,respectively. Tumor size（P = 0.025）, tumor differentiation type（P = 0.021）, depth of tumor invasion（P = 0.007）, lymph node staging（P〈0.001）, lymph node metastasis rate（P〈0.001）, TNM staging（P〈0.001）, PLR（P〈0.001）,NLR（P〈0.001） and surgical approach（P = 0.013） were significantly correlated with survival rate by univariate analysis. Multivariate analysis showed that lymph node metastasis rate（P = 0.004）, TNM staging（P = 0.005）, PLR（P = 0.001） could be independent risks factor for the prognosis of gastric cancer. Conclusion： PLR and NLR can be used to evaluate the prognosis of patients. PLR may be an independent risk factor for the overall survival rate.