血常规及乳酸脱氢酶与胃癌根治术后患者预后的相关性研究

Association of blood routine and lactate dehydrogenase with the prognosis of patients after radical gastrectomy

目的探讨中性粒细胞与淋巴细胞比值(neutrophil-to-lymphocyte,NLR)、淋巴细胞与单核细胞比值(lymphocyte-to-monocyte ratio,LMR)、血小板与淋巴细胞比值(platelet-to-lymphocyte ratio,PLR)、乳酸脱氢酶(LDH)与胃癌根治术后患者预后的相关性。方法收集110例在我院胃肠外科行根治性胃癌手术患者的病理学资料及随访资料,利用Kaplan-Meier法计算生存率,Log rank检验分析不同分组之间的差异,应用Cox回归分析影响根治性胃癌术后预后的因素。结果随访病例共110例,其中Ⅰ~Ⅱ期40例,Ⅲ期70例。全组患者随访13~96个月,中位随访时间为80.9个月。110例随访患者中,有44例死于胃癌,66例仍生存。对不同临床病理因素胃癌患者的生存情况进行分析显示,不同TNM分期、淋巴结转移、NLR和LDH水平的胃癌患者预后的差异具有统计学意义(均P<0.05),而不同年龄、性别、肿块大小、分化程度、PLR和LMR水平的患者预后的差异无统计学意义(P>0.05)。不同NLR、PLR水平患者的肿瘤分化程度差异明显(均P<0.05);不同LMR、LDH水平患者的TNM分期不同(均P<0.05);LDH还与PT分期即局部浸润程度有关,差异具有统计学意义(P<0.05)。对影响胃癌患者预后的变量进行Cox多因素回归分析结果显示,TNM分期、NLR水平和LDH为影响胃癌患者预后的独立因素(均P<0.05)。结论TNM分期、NLR水平和LDH为影响胃癌患者预后的独立因素。

Objective To explore the association of neutrophil-to-lymphocyte ratio(NLR),lymphocyte-to-monocyte ratio(LMR),platelet-to-lymphocyte ratio(PLR),lactic dehydrogenase with the prognosis of patients after radical gastrectomy.Methods A total of 110 patients who underwent radical gastrectomy in Fujian Provincial Cancer Hospital were enrolled.Their pathological and follow-up data were collected.The survival rate was calculated by the Kaplan-Meier method.The differences among different groups were analyzed by Log-rank.The prognostic factors of radical gastrectomy were analyzed by Cox regression model.Results A total of 110 patients were followed-up in the current study,including 40 cases on phaseⅠ/Ⅱand 70 cases on phaseⅢ.All the patients were followed up for 13-96 months,with a median follow-up time of 80.9 months.Among these 110 patients,44 died of gastric cancer and 66 survived.According to the survival of gastric cancer patients with different clinicopathological factors,the prognosis of gastric cancer patients was statistically different from TNM stage,lymph node metastasis,NLR and LDH(P<0.05),rather than age,sex,tumor size,differentiation degree,PLR,and LMR.Patients with different NLR and PLR levels presented various degree of tumor differentiation(P<0.05).Patients with different LMR and LDH levels showed various TNM stage(P<0.05).LDH was also related to PT stage,namely local infiltration degree(P<0.05).Cox multivariate regression analysis was performed on the variables affecting the prognosis of patients with gastric cancer,and the results showed that TNM stage,NLR level and LDH were independent factors affecting the prognosis of patients with gastric cancer(P<0.05).Conclusions TNM stage,NLR level and LDH are independent factors affecting the prognosis of patients with gastric cancer.