血常规对胃癌的预后的评估价值的研究进展  

Research progress of peripheral blood count test in the evaluation of prognosis of gastric cancer

作　　者：徐正水 程华[1] Xu Zhengshui Cheng Hua(Department of Gastrointestinal Surgery, The Second Affiliated hospital to Nanchang University, Nanchang 330006, Chin)

机构地区：[1]南昌大学第二附属医院胃肠外科,330006

出　　处：《中华胃肠外科杂志》2017年第2期236-240,共5页Chinese Journal of Gastrointestinal Surgery

摘　　要：胃癌是全世界最常见的恶性肿瘤之一，是威胁公共健康和导致人类死亡的主要原因之一。最近越来越多的研究已经证实系统性炎性反应与胃癌预后和治疗效果有关联性。其中外周血常规能一定程度的反应全身系统性炎性反应的情况。在血常规的基础上，许多研究证实了外周血血小板、中性粒细胞、淋巴细胞、白细胞的计数、中性粒细胞／淋巴细胞比值（NLR）、血小板／淋巴细胞比值（PLR）等血常规标记物与胃癌患者预后及治疗效果有关。其中，术前血小板计数可能和胃癌淋巴结转移、肿瘤浆膜浸润、肿瘤分期以及总体生存有关，且术前血小板升高而术后正常者，术后定期检测血小板计数可一定程度预测胃癌的复发。中性粒细胞升高的胃癌患者预后较差。术前淋巴细胞减少是胃癌患者的预后独立危险因素．术前淋巴细胞减少的胃癌患者其病理分型相对较差、TNM分期较晚，总体生存率和无病生存率均较低。血常规相关计数的比值及其联合运用与胃癌预后的关系也受到关注。术前高中性粒细胞／淋巴细胞计数的比值（NLR）与高淋巴结转移、肿瘤浸润深度、肿瘤分期和总体生存有关。血小板／淋巴细胞比值（PLR）在胃癌预后评估中的价值争议较大，有待进一步研究，大多数研究结果认为PLR是胃癌的预后的危险因素，而不能作为独立危险因素。然而目前关于血常规在胃癌的研究中仍存在标准缺乏统一、研究的群体较小、机制尚不清楚等局限。本文就血常规对胃癌预后的评估价值的研究进展作一综述。Gastric cancer （GC） is one of the most common tumor in the world, and remains a major public health problem and one of the leading causes of death. Recently many researches have demonstrated that systemic inflammatory response is associated with prognosis and response to therapy in gastric cancer, and the peripheral blood count test can partly reflect the systemic inflammatory response. Based on the peripheral blood count test, there are a lot of research regarding the relation between the platelet count （PLT）, neutrophil, lymphocyte, white blood cell （WBC）, neutrophil to lymphocyte ratio （NLR）, platelet to lymphocyte ratio （PLR） with their prognostic role in gastric cancer. A high PLT and preoperative lymphocytopenia are both associated with increased lymph node metastasis, stage （Ⅲ ＋ Ⅳ ）, serosal invasion （T3 ＋T4） risk and poorer overall survival. Besides above, platelet monitoring following surgery can be applied to predict the recurrence for patients with GC that suffer preoperative high PLT but have restored PLT levels following resection. Moreover systemic inflammatory factors based on blood parameters, such as PLR, NLR and so on, have relation with the poor prognosis of patients with GC. Among them, high NLR is a negative predictor of prognosis in GC patients. However PLR remains inconsistent, while most researches demonstrated high PLR may be useful prognostic factor rather than independent prognostic factor. There are still some limitations which include various cut-off values, little of clinician attention, the uncertain mechanism, etc. Here we review the research progress in the prognostic role of the blood count test in gastric cancer.

关 键 词：胃肿瘤 血常规 预后 

分 类 号：R735.2[医药卫生—肿瘤]