术前血小板与淋巴细胞计数比值预测进展期胃癌腹膜转移

Preoperative platelet-to-lymphocyte count ratio predicts peritoneal metastasis in patients with advanced gastric cancer

目的研究进展期胃癌患者术前血小板与淋巴细胞计数比值(platelet-to-lyrnphocyte ratio,PLR)和中性粒细胞与淋巴细胞计数比值(neutrophil-to-lymphocyte ratio,NLR)在腹膜转移中的预测价值.方法回顾性分析2009年1月至2012年1月在温州医科大学附属第一医院行手术治疗的701例经术后病理确诊的进展期胃癌患者的临床病理资料.结果单因素分析结果表明,进展期胃癌腹膜转移与肿瘤位置、肿瘤大小、浆膜浸润、分化程度、淋巴结转移及PLR均有关(均P<0.05).根据ROC曲线,PLR预测进展期胃癌腹膜转移的最佳阈值为132.43(灵敏度71.8%,特异度50.6%).高PLR组与低PLR组胃癌患者的肿瘤大小、TNM分期、淋巴结转移及浆膜浸润差异均有统计学意义(均P<0.05).Logistic多因素回归分析结果显示,进展期胃癌腹膜转移的独立危险因素有肿瘤大小(HR=1.150,P=0.014)、PLR(HR=2.205,P=0.003)及淋巴结转移(HR=3.113,P=0.010).结论术前PLR具有预测进展期胃癌腹膜转移的价值,并且是影响胃癌腹膜转移的独立危险因素.

Objective To assess the predictive value of the platelet-to-lymphocyte ratio (PLR),neutrophil-to-lymphocyte ratio (NLR) and tumor-related factors on the peritoneal metastasis in advanced gastric cancer patients.Methods A total of 701 pathologically confirmed gastric cancer patients who underwent surgery at the First Affiliated Hospital of Wenzhou Medical University between Jan 2009 and Jan 2012 were enrolled.Results Univariate analysis indicated that tumor location,tumor size,serosal invasion,depth of invasion,pathological type,lymph node metastasis and PLR were related to peritoneal metastasis(all P < 0.05).According to the area under the ROC curve,the optimal cutoff value of PLR for predicting peritoneal metastasis was 132.43 (sensitivity 71.8%,specificity 50.6%).There were significant differences in tumor size,TNM stage,lymph node metastasis and serosal infiltration between high PLR group and low PLR group.Multivariate Logistic analyses revealed that PLR (HR =2.205,P =0.003),lymph node metastasis(HR =3.113,P =0.010) and tumor size (HR =1.150,P =0.014) were independent risk factors for peritoneal metesfasis.Conclusions Preoperative PLR is valuable in predicting peritoneal metastasis of advanced gastric cancer and it is an independent risk factor for peritoneal metastasis of gastric cancer.