术前血小板/淋巴细胞比值对胃癌根治术后病人预后的影响

Effects of preoperative platelet/lymphocyte ratio on the prognosis of patients with radical gastrectomy for gastric cancer

目的探讨术前血小板/淋巴细胞比值(platelet/lymphocyte ratio,PLR)与胃癌病人预后的关系,分析影响病人预后的相关因素。方法 2013年1月~2015年12月我院收治的胃癌病人267例,采用Kaplan-Meier法绘制生存曲线,Log-rank检验进行生存分析和单因素分析,多因素生存分析采用Cox比例风险模型。结果术前PLR均值为177.2±109.9,据此将病人分为低PLR组(PLR<177.2,167例)及高PLR组(PLR≥177.2,100例)。高PLR组病人的中位生存时间为17个月,5年累积生存率为22.9%;低PLR组病人的中位生存时间为33个月,5年累积生存率为41.2%,两者比较差异有统计学意义(P<0.05)。单因素分析显示,年龄、肿瘤大小、Borrmann分型、T分期、N分期、TNM分期、CEA值及PLR是影响胃癌病人预后的相关因素(P<0.05)。多因素分析显示,年龄≥65岁、肿瘤直径≥5 cm、TNM分期为Ⅲ期及高PLR是影响胃癌病人预后的独立危险因素(P<0.05)。结论胃癌病人术前PLR值较高提示预后不良。

Objective To investigate the relationship between preoperative platelet/lymphocyte ratio(PLR) and prognosis in patients with gastric cancer,and analyze factors affecting the prognosis of patients.Methods The clinical and prognostic data of 267 patients with gastric cancer who were admitted to the Secend Hospital of Anhui Medical University form January 2013 to December 2015 were retrospective analyzed.The survival curve was drawn by Kaplan-Meier method.The survival analysis and univariate analysis were done using the Log-rank test,and multivariate analysis was done using the COX proportional hazards model.Resrults The mean preoperative PLR in the 267 patients was 177.2±109.9.According to the preoperative PLR,the patients were divided into the low PLR group(PLR<177.2,n=167) and the high PLR group(PLR≥177.2,n=100).The median survival time and 5-year cumulative survival rate of the high PLR group and the low PLR group were 17 months and 22.9%,33 months and 41.20%,respectively,with a significant difference in the survival of patients in low and high PLR groups(P<0.05).The results of univariate analysis showed that age,tumour size,Borrmann type,T stage,N stage,TNM stage,carcinoembryonic antigen value and PLR were factors affecting the prognosis of patients with gastric cancer(P<0.05).The results of multivariate analysis showed that age more than 65 years,tumour size more than 5 cm,stage Ⅲ and high PLR were independent risk factors affecting the prognosis of patients with gastric cancer(P<0.05).Conclusion High preoperative PLR corresponded to poor prognosis of patients with gastric cancer.