胶质瘤患者NLR、PLR、纤维蛋白原、PDW与临床病理分级的相关性研究

Correlation between NLR,PLR,fibrinogen,PDW and clinical pathological grade in glioma patients

目的研究胶质瘤患者炎症相关指标的变化,探讨其与胶质瘤恶性程度的相关性。方法回顾性分析徐州医科大学附属医院神经外科2015年1月至2018年5月收治的119例胶质瘤患者的临床资料。所有患者均有明确的临床、病理学诊断分级及血液学检查结果,其中经术后病理检查明确诊断的WHOⅠ级毛细胞星型细胞瘤25例,WHOⅡ级节细胞胶质瘤和星型少突胶质细胞瘤29例,WHOⅢ级间变性星型细胞瘤29例,WHOⅣ级胶质母细胞瘤36例。采用方差分析和等级相关性分析炎性指标与临床病理特征之间的关系。结果方差分析结果显示中性粒细胞计数、淋巴细胞计数、血小板分布密度(PDW)、平均血小板体积、白蛋白、纤维蛋白原、中性粒细胞计数/淋巴细胞计数(NLR)、血小板计数/淋巴细胞计数(PLR)均为胶质瘤病理学恶性程度分级的影响因素(P <0. 05),等级相关分析显示NLR、PLR、纤维蛋白原、PDW与WHO分级均有明显的等级正相关性(r分别为0. 433、0. 287、0. 357、0. 261,P <0. 05)。结论胶质瘤患者NLR、PLR、纤维蛋白原、PDW与胶质瘤恶性程度有关,对胶质瘤患者术前病理分级预测有一定的参考价值。

Objective To study the changes of inflammation-related indicators in patients with glioma and to explore its correlation with the malignant grades of glioma. Methods The clinical data of 119 glioma patients admitted to the affiliated hospital of Xuzhou medical university from January 2015 to May 2018 were investigated in a retrospective analysis. All patients had clearly clinical and pathological diagnosis grades and hematological examination results,who were confirmed by postoperative pathological examinations,including 25 cases with pilocytic astrocytoma in WHO Ⅰ grade,29 cases with oligodendro glioma in WHO Ⅱ grade,29 cases with anaplastic astrocytoma in WHO grade Ⅲ,36 cases with glioblastoma in WHO Ⅳ grade. The relationship between inflammatory markers and clinicopathological features was analyzed by analysis of variance and rank correlation. Results Analysis of variance showed that neutrophil count,lymphocyte count,platelet distribution width,mean platelet volume,albumin,fibrinogen,NLR( neutrophil count/lymphocyte ratio),PLR( platelet/lymphocyte ratio) were associated with glioma pathological malignancy( P < 0. 05). Spearman correlation analysis showed that there was positive correlation between NLR,PLR,fibrinogen,platelet width and WHO grade( r = 0. 433,0. 287,0. 357,0. 261,P < 0. 05). Conclusion The levels of the width of NLR,PLR,fibrinogen and platelet distribution in patients with glioma were related to the degree of malignant glioma,and it has some reference value for preoperative pathological grading prediction of patients with glioma.