胃癌患者中性粒细胞与淋巴细胞比值及血小板与淋巴细胞比值的变化及临床意义  

Clinical significance of neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio in gastric cancer patients

作　　者：李祯[1] 张之芬[1] 韩静颖 刘天璞 李丽[1] 王子娥[1] 鞠瑛[1] Li Zhen;Zhang Zhifen;Han Jingying;Liu Tianpu;Li Li;Wang Zi'e;Ju Ying(Department of Laboratory Medicine,Shandong Provincial Hospital Affiliated to Shandong University,Jinan 250021,China)

机构地区：[1]山东大学附属省立医院临床医学检验部,济南250021

出　　处：《中国医药》2018年第12期1857-1860,共4页China Medicine

基　　金：国家自然科学基金(81000731);山东省优秀中青年科学家科研奖励基金(BS2010YY045)~~

摘　　要：目的探讨胃癌患者中性粒细胞与淋巴细胞比值(NLR)及血小板与淋巴细胞比值(PLR)的变化及临床意义。方法选取2015年7月至2017年6月在山东大学附属省立医院治疗的胃癌患者共224例(胃癌组)和同期健康体检者135名(健康对照组)。清晨空腹抽血,检测NLR、PLR、血清癌胚抗原、糖类抗原199和糖类抗原724水平。利用受试者工作特征(ROC)曲线评价NLR和PLR对胃癌的诊断价值。结果胃癌组NLR和PLR均明显高于健康对照组,差异均有统计学意义[2. 79(1.65,6.43)比1.70(1. 36,2. 13), 176.15(123. 64,246. 35)比119.38(92.74,142. 33)](均P<0.001)。通过ROC曲线确定NLR和PLR最佳截点,将胃癌患者分为低NLR组(NLR <2. 975)和高NLR组(NLR≥2.975)、低PLR组(PLR<157.74)和高PLR组(NLR≥157.74)。高NLR组糖类抗原724水平明显高于低NLR组[5.63(2.40,17.72)kU/L比1. 81 (1. 13,5.94)kU/L](P=0. 003),癌胚抗原和糖类抗原199水平差异无统计学意义(P> 0. 05)。高PLR组糖类抗原724水平明显高于低PLR组[5. 13 (1.97,16.49) kU/L比1. 85(1.20,7.05)kU/L](P=0.040),癌胚抗原和糖类抗原199水平差异无统计学意义(P>0.05)。结论胃癌患者的NLR和PLR显著高于正常人群,高NLR和PLR患者糖类抗原724水平显著升高,提示NLR和PLR在胃癌辅助诊断中有重要意义。Objective To investigate the clinical significance of neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio(PLR)in gastric cancer patients.Methods From July 2015to June 2017,224 patients with gastric cancer and 135healthy people were enrolled in Shandong Provincial Hospital Affiliated to Shandong University.Fasting blood was taken in the morning and NLR,PLR,carcinoembryonic antigen(CEA), carbohydrate antigen(CA)199,CA724were tested.Diagnostic values of NLR and PLR for gastric cancer were analyzed using receiver operating characteristic (ROC)curve.Results NLR and PLR in gastric cancer group were significantly higher than those in healthy control group [2.79(1.65,6.43)vs 1.70(1.36,2.13);176.15 (123.64,246.35)vs 119.38(92.74,142.33)](P <0.001).According to the optimum cut point of ROC curve, gastric cancer patients were divided into low NLR group(NLR <2.975)and high NLR group (NLR >2.975),low PLR group(PLR <157.74)and high PLR group(PLR >157.74).CA724level in the high NLR group was significantly higher than that in the low NLR group [5.63(2.40,17.72)kU/L vs 1.81(1.13,5.94)kU/L ](P = 0.003);CEA and CA199showed no significant difference between groups (P >0.05).CA724level in the high PLR group was significantly higher than that in the low PLR group [5.13(1.97,16.49)kU/L vs 1.85(1.20, 7.05)kU/L](P=0.040);CEA and CA199showed no significant difference(P >0.05).Conclusions NLR and PLR increase in gastric cancer patients.CA724increases in patients with high NLR and PLR.

关 键 词：胃肿瘤 中性粒细胞与淋巴细胞比值 血小板与淋巴细胞比值 癌胚抗原 糖类抗原 

分 类 号：R735.2[医药卫生—肿瘤]