不同危险度分级胃肠道间质瘤患者NLR与PLR变化及其与预后的相关性

Changes of NLR and PLR and their correlation with prognosis in patients with gastrointestinal stromal tumors in different risk grades

目的:探讨不同危险度分级胃肠道间质瘤患者中性粒细胞与淋巴细胞比值(NLR)、血小板与淋巴细胞比值(PLR)的变化及其与预后的相关性。方法:抽取濮阳市人民医院2016年1月至2017年1月收治的90例胃肠道间质瘤(GIST)患者,根据美国国立卫生研究院标准将其分为低危组32例,中危组31例,高危组27例,再选取同期体检健康者30例为对照组。比较各组间NLR、PLR水平。通过Logrank检验及Cox回归模型分析影响预后的因素。结果:对照组、低危组、中危组、高危组NLR、PLR水平依次升高,两两组间比较差异有统计学意义(P<0.05);影响GIST患者预后的单因素包括肿瘤直径大、核分裂象大、NLR水平高、PLR水平高、NIH分级高(P<0.05),与性别、年龄、肿瘤部位无关(P>0.05);肿瘤长径大、核分裂象大、NLR水平高、PLR水平高、NIH分级高是影响GIST患者预后的危险因素(P<0.05)。结论:危险度分级越高的GIST患者NLR、PLR水平越高,NLR、PLR水平高是影响GIST患者预后的独立因素。

Objective To investigate the changes of neutrophil-lymphocyte ratio(NLR)and platelet-lymphocyte ratio(PLR)and their correlation with prognosis in patients with gastrointestinal stromal tumors in different risk grades.Methods A total of 90 patients with gastrointestinal stromal tumors in Puyang People's Hospital from January 2016 to January 2017 were enrolled,and divided into three groups according to classification criteria of National Institutes of Health,they were low-risk group(n=32),medium risk group(n=31),and high-risk group(n=27);Another 30 healthy persons in the same period were selected as the control group.The ratio of NLR and PLR in each group were compared.Logrank test and Cox risk regression model were used to analyze the prognostic factors of patients with gastrointestinal stromal tumors.Results NLR and PLR among four groups were the lowest in control group,followed by low-risk group,medium risk group,and high-risk group,and statistic difference was found in paired comparison(P<0.05).Factors including large tumor diameter,large tumor mitosis,high NLR,high PLR,and high NIH grade influenced the prognosis of GIST patients,while the prognosis had no correlation with the gender,age and tumor location(P>0.05).Large tumor diameter,large mitosis,high NLR,high PLR and high NIH grade were independent risk factors affecting the prognosis of GIST patients(P<0.05).Conclusions GIST patients of high risk have high NLR and PLR,moreover,elevated NLR and PLR are independent risk factors affecting the prognosis of GIST patients.