中性粒细胞与淋巴细胞比值联合纤维蛋白原检测对胃肠道间质瘤的预后价值探讨

Prognostic value of neutrophil lymphocyte ratio combined with fibrinogen detection in gastrointestinal stromal tumors

目的 探讨中性粒细胞与淋巴细胞比值(NLR)以及纤维蛋白原(FIB)含量对胃肠道间质瘤(GIST)患者预后的预测价值。方法 收集手术治疗的265例GIST患者的临床资料,回顾性分析术前NLR、FIB及二者联合对GIST患者预后的预测价值。结果 以出现复发或转移为结局绘制ROC曲线显示,当NLR=1.86、FIB=2.71 g/L时,NLR、FIB预测GIST患者预后的敏感性和特异性最高。Kaplan-Meier生存分析结果显示,高NLR组(NLR≥1.86)GIST患者的无复发生存期(RFS)及总生存期(OS)低于低NLR组(NLR<1.86,P<0.05),高FIB组(FIB≥2.71 g/L)GIST患者的RFS及OS低于低FIB组(FIB<2.71 g/L,P<0.05)。多因素Cox分析显示,肿瘤直径、NLR是影响GIST患者预后的独立影响因素(P<0.05)。结论 术前NLR、FIB升高的GIST患者预后较差,NLR与FIB联合检测是一种简单、低成本的预后指标,可用于临床上辅助判断术后GIST患者的预后。

Objective To investigate the predictive value of neutrophil to lymphocyte ratio(NLR)and fibrinogen(FIB)content in patients with gastrointestinal stromal tumor(GIST).Methods The clinical data of 265 patients with GIST who underwent surgical treatment were collected.The predictive value of preoperative NLR,FIB and their combination on the prognosis of GIST patients were retrospectively analyzed.Results The ROC curve based on recurrence or metastasis showed that when NLR=1.86 and FIB=2.71 g/L,the sensitivity and specificity of NLR and FIB in predicting the prognosis of GIST patients were the highest.Kaplan Meier survival analysis showed that the RFS and OS of GIST patients in the high NLR group(NLR≥1.86)were lower than those in the low NLR group(NLR<1.86,P<0.05),and the RFS and OS of GIST patients in the high FIB group(FIB≥2.71 g/L)were lower than those in the low FIB group(FIB<2.71 g/L,P<0.05).Multivariate Cox analysis showed that tumor diameter and NLR were independent factors affecting the prognosis of GIST patients(P<0.05).Conclusion The prognosis of GIST patients with high preoperative NLR and FIB is poor.The combined detection of NLR and FIB is a simple and affordable prognostic index that can be utilized to assess the prognosis of postoperative GIST patients.