中性粒细胞与淋巴细胞比值联合纤维蛋白原检测对胃肠道间质瘤预后的判断价值

Combined fibrinogen concentration and neutrophil-lymphocyte ratio as a prognosis indicator for gastrointestinal stromal tumors

目的 探讨中性粒细胞与淋巴细胞比值(neutrophil-to-lymphocyte ratio,NLR)和血浆纤维蛋白原(fibrinogen,FIB)联合指标(FIB-NLR)对胃肠道间质瘤(gastrointestinal stromal tumors,GIST)患者预后的判断价值.方法 回顾性分析2010年6月至2014年12月在温州医科大学附属第二医院手术治疗的79例GIST患者的临床病理资料.将患者分成3组:NLR<2.30和血浆FIB<3.85 g/L为FIB-NLR 0分组,NLR≥2.30和血浆FIB< 3.85 g/L或者NLR<2.30和血浆FIB≥3.85 g/L为1分组,NLR≥2.30和血浆FIB≥3.85 g/L为2分组,比较3组GIST患者的临床病理特征和术后5年无复发生存率情况.结果 血浆FIB浓度和NLR值与GIST患者的NIH危险度分级和肿瘤大小均有关(χ^2 =9.517、12.411,6.081、20.067,均P<0.05);FIB-NLR与肿瘤大小、肿瘤危险度和肿瘤核分裂象均有关(χ^2=14.406、12.514、28.225,均P<0.05);FIB-NLR评分高组患者的5年无复发生存率比FIB-NLR评分低组低,差异具有统计学意义(0分组为87.4%,1分组为60.8%,2分组为21.1%,χ^2=29.617,P=0.000).结论 FIB-NLR可能是一个判断GIST患者预后的指标.

Objective To evaluate FIB-NLR,a combined neutrophil-lymphocyte ratio (NLR) and fibrinogen concentration (FIB) in predicting the prognosis of gastrointestinal stromal tumors (GIST).Methods Data of 79 GIST patients who underwent surgery from Jun 2010 to Dec 2014 were retrospectively analyzed.Patients were divided into 3 groups:NLR < 2.30 and FIB < 3.85 g/L were defined as group 0,NLR≥2.30 and FIB <3.85 g/L or NLR <2.30 and FIB≥3.85 g/L as group 1,NLR≥2.30 and FIB≥3.85 g/L as group 2.The clinicopathological features of the three groups and the 5-year recurrence-free survival rate after surgery were compared.Results FIB concentration and NLR were significantly correlated with NIH risk grade and tumor size in GIST patients (χ^2 =9.517,12.41 1,6.081,20.067,all P < 0.05).FIB-NLR was closely related to tumor size,tumor risk and tumor mitosis (χ^2 =14.406,12.514,28.225,all P < 0.05).Survival analysis showed that high FIB predicts lower 5-year recurrence-free survival rate,it was 87.4% for group 0,60.8% for group 1,21.1% for group2,x2 =29.617,P<0.000).Conclusion FIB-NLR independently predicts the prognosis of gastrointestinal stromal tumors.