术前PLR、LMR与胃癌患者预后的相关性研究

Correlation between preoperative platelet-to-lymphocyte ratio and lymphocyte-to-monocyte ratio with prognosis of gastric cancer

目的探讨术前血小板与淋巴细胞比值(PLR)、淋巴细胞与单核细胞比值(LMR)在预测胃癌患者生存预后中的意义。方法选取2011年1月至2017年12月海南省人民医院收治的112例胃癌患者,回顾性分析其临床资料,通过受试者工作特征曲线(ROC曲线)选取PLR、LMR预测胃癌预后的截点,据此将112例患者分为低PLR组(PLR<152.73)67例、高PLR组(PLR≥152.73)45例,低LMR组(LMR<2.99)22例、高LMR组(LMR≥2.99)90例;比较不同PLR分组、LMR分组患者的临床资料,采用单因素和Cox回归分析影响预后的高危因素。结果低PLR组和高PLR组在肿瘤直径、分化程度及TNM分期方面差异有统计学意义,在年龄、性别、淋巴结转移方面差异无统计学意义。低LMR组和高LMR组在性别、淋巴结转移方面差异有统计学意义,在年龄、肿瘤直径、分化程度、TNM分期方面差异无统计学意义。单因素和多因素Cox回归分析结果均显示,术前PLR高值、术前LMR低值与肿瘤TNM分期高均为影响胃癌术后无病生存率的危险因素。结论术前PLR、LMR与胃癌患者预后有相关性,术前PLR高值、LMR低值是影响胃癌预后的独立危险因素。

Objective To discuss the value of the platelet-to-lymphocyte ratio (PLR),and lymphocyte-to-monocyte ratio (LMR) to the prognosis of patients with gastric cancer.Methods In this retrospective analysis,112 patients' clinical data with gastric cancer treated in the Hainan Province People's Hospital from January 2011 to December 2017.ROC curve was performed to select the thresholds for PLR and LMR in the summit of Youden index.Sixty-seven patients were in low PLR group (PLR<152.73)and 45 patients were in the high PLR group(PLR≥152.73),as well as 22 patients were in the low LMR group(LMR<2.99) and 90 patients were in the high LMR group(LMR≥2.99).The Chi-square test,Kaplan-Meier,Log-rank,Cox were performed for the analysis of prognostic factors.Results When the threshold of PLR reached 152.73 and the threshold of LMR was 2.99,the Youden index and the predictive value had the summit points.There were statistically significant differences in tumor diameter,differentiation,and TNM staging between the low PLR group and the high PLR group.Also,There were statistically significant differences in gender and lymph node metastasis between the low LMR group and the high LMR group.It was shown in the analysis of single factor,PLR,LMR and TNM stage are the risk factors for the survival and prognosis of patients with gastric cancer.In the analysis of multiple factors,PLR,LMR,and TNM stage were the independent risk factors for the survival and prognosis of patients with gastric cancer ( P < 0.05).Conclusions PLR and LMR are the independent risk factors for the survival and prognosis of patients with gastric cancer.