探讨三种生化指标比值水平与CT增强显影联合诊断胃癌患者手术前后的临床价值

Clinical Value of Diagnosis of Three Biochemical Indexes Ratio Levels Combined Determination with MSCT in Patients with Gastric Cancer

目的探讨三种生化指标比值水平与CT增强显像(multi-slice spiral computed tomography,MSCT)联合胃癌早期诊断、严重程度和预后随访的临床价值。方法采用化学法测定126例胃癌(Ⅰ-Ⅳ期)术前的中性粒细胞/淋巴细胞比值(neutrophil to lymphocyte ratio,NLR)、血小板/淋巴细胞比值(platelet to lymphocyte ratio,PLR)和C-反应蛋白/白蛋白比值(C-reactive protein to albumin ratio,CAR),并与131例胃良性疾病和120名正常对照组进行了对比性分析。观察术后胃癌的肿瘤位置、肿块大小、浸润程度、淋巴结转移和远端转移。对MSCT与NLR、PLR和CAR水平进行了相关性分析。结果胃癌的危险因素是吸烟、酗酒、WBC增高、贫血、BMI降低和HP-IgG阳性(P<0.05或0.01)。胃癌患者术前血清NLR、PLR和CAR水平较之胃良性疾病和正常对照组明显增高(P<0.01),并随胃癌Ⅰ-Ⅳ期严重程度而增高(P<0.05或0.01)。MSCT与NLR、PLR和CAR呈正相关,相关系数分别为0.246、0.562和0.733(P<0.05,P<0.01,P<0.01)。血清NLR、PLR和CAR水平与术后胃癌肿瘤位置无关,而与肿块大小、浸润程度、淋巴结转移和远端转移有关(P<0.05或0.01)。结论胃癌的危险因素是吸烟、酗酒、WBC增高、贫血、BMI降低和HP-IgG阳性。胃癌术前血清NLR、PLR和CAR与MSCT联检是早期诊断和严重程度有价值指标,亦具有术后评估胃癌肿瘤位置、肿块大小、浸润程度、淋巴结转移和远端转移的临床价值。

Objective To explore clinical value of early diagnosis,severity and therapy follow-up of three biochemical indexes ratio levels combined determination with multi-slice spiral computed tomography(MSCT)in patients with gastric cancer.Methods Neutrophil to lymphocyte ratio(NLR),platelet to lymphocyte ratio(PLR)and C-reactive protein to albumin ratio(CAR)were determined by chemical method in 126 patients with gastric cancer(stageⅠ-Ⅳ)before operation,and compared with 131 patients with benign gastric diseases and 120 normal controls.The tumor location,tumor size,invasion degree,lymph node metastasis and distant metastasis of postoperative gastric cancer patients were observed.The correlation between MSCT and NLR,PLR and CAR levels was analyzed.Results The dangerous factors of gastric cancer were smoking,drinking,increased WBC,anemia,lowed BMI and positive HP-IgG(P<0.05 or 0.01).The levels of serum NLR,PLR and CAR in patients with gastric cancer before operation were significantly higher than those in patients with benign gastric diseases and normal controls,and increased with the severity of gastric cancer(stageⅠ-Ⅳ,P<0.05 or 0.01).MSCT was positively correlated with NLR,PLR and CAR,with correlation coefficients of 0.246,0.562 and 0.733 respectively(P<0.05,P<0.01,P<0.01).The levels of serum NLR,PLR and CAR were not related to tumor location of gastric cancer after operation,but to tumor size,invasion degree,lymph node metastasis and distal metastasis(P<0.05 or 0.01).Conclusion The dangerous factors of gastric cancer were smoking,drinking,increased WBC,anemia,lowed BWI and positive HP-IgG.The combination of preoperative serum NLR,PLR,CAR and MSCT is a valuable index for early diagnosis and severity of gastric cancer,and also has clinical value for postoperative evaluation of tumor location,tumor size,invasion degree,lymph node metastasis and distant metastasis of gastric cancer.