中性粒-淋巴细胞比值与胃癌患者预后的关系  

Correlation between Neutrophil-to-lymphocyte Ratio and Prognosis in Patients with Gastric Cancer

作　　者：李倩[1] 郭魁元[1] 崔小兵[1] 傅聿铭[1] 闫军浩 Li Qian;Guo Kuiyuan;Cui Xi-aobing(Department of General Surgery,The Fifth Affiliated Hospital of Zhengzhou University,Henan 450052,China)

机构地区：[1]郑州大学第五附属医院普外科,450052

出　　处：《医学研究杂志》2018年第12期169-173,共5页Journal of Medical Research

摘　　要：目的探讨术前外周血中性粒细胞淋巴细胞比值(neutrophil to lymphocyte ratio,NLR)与胃癌患者预后的关系。方法回顾性分析2012年10月～2016年12月在郑州大学第五附属医院普外科行胃癌根治术且有完整临床数据162例患者的资料,采用时间依赖性受试者工作特征(receiver operating characteristic,ROC)曲线确定NLR预测术后患者生存情况的最佳截断值,并将患者分为高NLR组和低NLR组,比较两组患者的临床病理特征及预后情况,采用单因素和多因素COX回归模型分析影响患者预后的临床因素。结果 NLR最佳截断值为3.11,由此将患者分为低NLR组(NLR≤3.11,n=116)和高NLR组(NLR>3. 11,n=46)。两组患者的年龄、T分期、术前白蛋白含量、CA242水平及术后生存情况比较,差异有统计学意义(P值均<0.05)。单因素分析显示年龄、分化程度、TNM分期、T分期、N分期、术前血红蛋白含量、术前白蛋白含量、CEA水平、CA199水平、CA242水平及NLR与患者预后显著相关(P均<0.05)。多因素分析结果显示,年龄(HR=3.086,95%CI:1.835～5.192)、术前白蛋白含量(HR=0.405,95%CI:0.242～0.679)、CA199水平(HR=2.773,95%CI:1.033～7.448)及NLR(HR=2.736,95%CI:1.645～4.551)是影响胃癌患者预后的独立因素(P均<0.05)。结论术前外周血NLR可作为胃癌患者的预后标志物,高NLR值提示预后较差。Objective To investigate the correlation between pre-operative neutrophil-to-lymphocyte ratio(NLR) in peripheral blood and prognosis in patients with gastric cancer. Methods The clinical data of 162 patients undergoing radical gastrectomy in General Surgery Department of The Fifth Affiliated Hospital of Zhengzhou University from October 2012 to December 2016 were analyzed retrospectively. The optimal cutoff value of NLR for prediction of patients’ survival was determined by employing time-dependent receiver operating characteristic(ROC) curve, and thereby patients were divided into low NLR and high NLR groups. The clinicopathological features and prognosis of the two groups were compared. The clinical factors affecting patients’ survival were analyzed through univariate and multivariate COX regression model. Results The optimal cutoff value of NLR was 3. 11 and patients were accordingly divided into low NLR group(NLR≤3.11, n = 116) and high NLR group(NLR >3.11, n =46). Significant differences were observed between the two groups in age, T stage, pre-operative albumin, CA242 level and post-operative survival( all P < 0. 05). Univariate COX analysis showed that age, differentiated degree, TNM stage, T stage, N stage, pre-operative hemoglobin, pre-operative albumin, CEA level, CA199 level,CA242 level, and NLR were significantly correlated with prognosis of patients(all P < 0.05). Multivariate COX analysis revealed that age(HR =3.086, 95% CI: 1.835 ~5. 192), pre-operative albumin(HR =0.405, 95% CI: 0. 242-0.679), CA199 level(HR =2.773, 95% CI: 1.033-7.448) and NLR(HR =2.736, 95% CI: 1.645-4.551) were independent prognosis factors for gastric cancer patients(all P < 0. 05). Conclusion Pre-operative NLR in peripheral blood could serve as a prognostic biomarker for gastric cancer patients. High NLR value was associated with poor prognosis.

关 键 词：胃癌 中性粒细胞淋巴细胞比值 生存 预后 

分 类 号：R73[医药卫生—肿瘤]