专题研究(Monographic Study)

胃癌患者术前中性粒细胞与淋巴细胞比与临床病理特征及预后关系

Published at: 2016年第25卷第10期

韩文秀 1 , 徐阿曼 1 , 张理想 1 , 陈章明 1
1 安徽医科大学第一附属医院 胃肠外科,安徽 合肥 230022
通讯作者 阿曼 徐 Email: xamhwx@163.com
DOI: 10.3978/j.issn.1005-6947.10.3978/j.issn.1005-6947.2016.10.005
基金:
国家自然科学基金资助项目 81572350

摘要

目的:探讨胃癌患者术前中性粒细胞与淋巴细胞比(NLR)与临床病理特征及预后的关系。方法:回顾性分析2010年1月—2011年1月安徽医科大学第一附属医院收治的269例胃癌患者的临床病理及随访资料。根据受试者工作特征曲线,确定NLR的截断值为2.4(敏感性:53.3%,特异性:71.4%),将患者分为低NLR组(NLR<2.4,153例)和高NLR组(NLR≥2.4,116例),比较两组患者临床病理特征及生存率的差异,并分析胃癌患者的预后因素。结果:比较结果显示,两组年龄、性别、淋巴结转移无明显差异(均P>0.05),但高NLR组较低NLR组肿瘤直径大、肿瘤浸润深度深、TNM分期高(均P<0.05);全组患者5年总生存率为44.3%,生存分析显示,高NLR组患者总生存率明显低于低NLR组(χ2=17.511,P<0.01);单因素分析结果表明,术前NLR、肿瘤大小、肿瘤浸润深度和TNM分期与胃癌患者总生存率有关(均P<0.05),多因素分析显示,NLR和肿瘤大小为影响胃癌患者预后的独立因素(均P<0.05)。结论:术前NLR是影响胃癌患者预后的独立预测因素,高术前NLR值提示胃癌患者有较差的临床病理情况及生存预后。


Relations of preoperative neutrophil to lymphocyte ratio with clinicopathologic features and prognosis in gastric cancer

Abstract

Objective: To investigate the relations of preoperative neutrophil to lymphocyte ratio (NLR) with clinicopathologic characteristics and prognosis of patients with gastric cancer. Methods: The clinicopathologic and follow-up data of 269 patients with gastric cancer treated in the First Affiliated Hospital of Anhui Medical University between January 2010 and January 2011 were retrospectively analyzed. The cutoff value of NLR was 2.4 (susceptibility: 53.3%, specificity: 71.4%) that was determined by receiver operating characteristic curve, and then, according to that, the patients were divided into low NLR group (NLR<2.4, 153 cases) and high NLR group (NLR≥2.4, 116 cases). The differences in clinicopathologic characteristics and survival rates between the two groups of patients were compared, and the prognostic factors for gastric cancer patients were also analyzed. Results: The results of comparison showed that there was no significant difference in age, gender and lymph node metastasis between the two groups (all P>0.05), but the tumor diameter was larger, depth of tumor invasion was deeper, and TNM stage was higher in high NLR group than those in low NLR group (all P<0.05). The overall 5-year survival rate was 44.3% for the entire group, and the results of survival analysis showed that the overall survival rate in high NLR group was significantly lower than that in low NLR group (χ2=17.511, P<0.01). Univariate analysis indicated that the overall survival of the gastric cancer patients was significantly associated with preoperative NLR, tumor size, the depth of tumor invasion and TNM stage (all P<0.05), and multivariate analysis identified that preoperative NLR and tumor size were independent risk factors for the prognosis of gastric cancer patients (both P<0.05). Conclusion: Preoperative NLR is an independent prognostic factor for gastric cancer patients, and high preoperative NLR may associated with unfavorable clinicopathologic conditions and poor prognosis.


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引用

引用本文: 文秀 韩, 阿曼 徐, 理想 张, 章明 陈. 胃癌患者术前中性粒细胞与淋巴细胞比与临床病理特征及预后关系 [J]. 中国普通外科杂志, 2016, 25(10): 1397-1401.
Cite this article as: HAN Wenxiu, XU Aman, ZHANG Lixiang, CHEN Zhangming . Relations of preoperative neutrophil to lymphocyte ratio with clinicopathologic features and prognosis in gastric cancer [J]. Chin J Gen Surg, 2016, 25(10): 1397-1401.