胃癌患者外周血中性粒细胞及血小板与淋巴细胞比值与胃癌病理特征之间的关系

Relationship between the ratio of peripheral blood neutrophils and platelet to lymphocytes in patients with gastric cancer and the pathological characteristics of gastric cancer

目的探讨胃癌患者血清中性粒细胞与淋巴细胞比值(NLR)及血小板与淋巴细胞比值(PLR)与胃癌病理特征之间的相关性。方法选择2015年1月~2018年8月于徐州医科大学附属医院(以下简称“我院”)就诊的457例胃癌患者作为研究对象,以同期在我院体检的200名健康人群为对照组,分析两组NLR及PLR的差异,以及肿瘤浸润深度、淋巴结转移和TNM分期与NLR、PLR之间的相关性。结果胃癌组NLR、PLR均明显高于对照组,差异均有统计学意义(P<0.05)。NLR升高组(NLR≥2.44)患者较NLR降低组(NLR<2.44)、PLR升高组(PLR≥176.59)患者较PLR降低组(PLR<176.59)患者,有更大的肿瘤最大径、更差的分化程度、更深的浸润深度、更多的淋巴结转移和较晚的TNM分期,差异均有统计学意义(P<0.05)。NLR升高+PLR升高组淋巴结转移人数所占比例明显高于NLR降低+PLR升高组、NLR升高+PLR降低组及NLR降低+PLR降低组,差异均有统计学意义(P<0.05);NLR降低+PLR升高组、NLR升高+PLR降低组患者淋巴结转移率明显高于NLR降低+PLR降低组(P<0.05),其他各组间淋巴结转移率比较差异无统计学意义(P>0.05)。NLR和PLR之间存在明显正相关性(r=0.648,P<0.05)。结论胃癌患者NLR、PLR越高,提示肿瘤浸润程度越深、分化程度越低、淋巴结转移数目越多、肿瘤直径越大及TNM分期越晚,预后越差。

Objective To explore the correlation of serum neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) with pathological features of gastric cancer in patients with gastric cancer.Methods A total of 457 patients with gastric cancer who were admitted to the Affiliated Hospital of Xuzhou Medical University (“our hospital” for short) from January 2015 to August 2018 were enrolled in the study.The 200 healthy people taken physical examination in our hospital during the same period were used as the control group.The differences of NLR and PLR between the two groups were analyzed retrospectively.And the correlation between tumor invasion depth or lymph node metastasis or TNM staging and NLR or PLR was analyzed.Results NLR and PLR in the gastric cancer group were significantly higher than those in the control group,and the difference was statistically significant (P < 0.05).The patients in NLR elevation group (NLR≥2.44) were more likely to have larger tumor diameters,worse differentiation,deeper infiltration depth,more lymph node metastasis,and later TNM than those in the NLR reduction group (NLR<2.44),as well as PLR elevation group (PLR≥176.59) compared with PLR reduction group (PLR<176.59)(P < 0.05).The proportion of lymph node metastasis in patients with NLR elevation + PLR elevation group was significantly higher than that in NLR reduction + PLR elevation,NLR elevation + PLR reduction and NLR reduction + PLR reduction groups (P < 0.05).The lymph node metastasis rate of NLR reduction + PLR elevation group and NLR elevation + PLR reduction group was significantly higher than NLR reduction + PLR reduction group (P < 0.05),there was no significant difference in lymph node metastasis rate among the other groups (P > 0.05).There was a significant positive correlation between NLR and PLR (r = 0.648,P < 0.05).Conclusion The higher the NLR and PLR of gastric cancer patients,the deeper the degree of tumor infiltration,the lower the degree of differentiation,the greater the number of lymph node metastases,the larger the tumor diameter and the later the TNM stage,the worse the prognosis.