术前中性粒细胞淋巴细胞比率和红细胞分布宽度对胃肠道间质瘤患者预后的预测价值  

Value of preoperative neutrophil-lymphocyte ratio and red blood cell distribution width in predicting clinical prognosis of patients with gastrointestinal stromal tumors

作　　者：叶小龙[1] 魏波[1] 黄勇[1] 陈图锋[1] 刘健培[1] 黄江龙[1] 郑宗珩[1] 卫洪波[1] Ye Xiaolong;Wei Bo;Huang Yong;Chen Tufeng;Liu Jianpei;Huang Jianglong;Zheng Zongheng;Wei Hongbo(Department of Gastrointestinal Surgery,the Third Affiliated Hospital of Sun Yat-sen University,Guangzhou 510630,China)

机构地区：[1]中山大学附属第三医院胃肠外科

出　　处：《新医学》2020年第1期27-32,共6页Journal of New Medicine

基　　金：广东省科技计划项目（2017B020227009,2017A010103009）

摘　　要：目的研究术前中性粒细胞淋巴细胞比率(NLR)和红细胞分布宽度(RDW)对胃肠道间质瘤(GIST)患者预后的预测价值。方法回顾性分析2003至2013年中山大学附属第三医院收治的经手术治疗并符合入组标准的78例GIST患者的临床资料。根据术前NLR、RDW值将患者分为低NLR组(NLR≤3.85)、高NLR组(NLR>3.85)和低RDW组(RDW≤0.142)、高RDW组(RDW>0.142),分别比较2组间的临床病理因素,进行生存分析。结果术前NLR、RDW值与肿瘤大小、核分裂数、危险度分级、远处转移均相关(P均<0.05)。低NLR组患者的术后5年生存率高于高NLR组(91.3%vs. 0%;χ^2=74.805,P<0.05);低RDW组患者的术后5年生存率高于高RDW组(76.8%vs. 29.1%;χ^2=13.109,P<0.05)。多因素分析显示肿瘤大小(HR=3.568,95%CI 1.414~9.001)、核分裂数(HR=8.321,95%CI 1.515~45.684)、NLR (HR=35.254,95%CI 6.522~190.558)及RDW(HR=2.072,95%CI 1.141~3.761)是预后的独立影响因素(P<0.05)。结论术前NLR和RDW值可用于GIST患者的预后评估。Objective To evaluate the value of preoperative neutrophil-lymphocyte ratio(NLR) and red blood cell distribution width(RDW) in predicting the clinical prognosis of patients diagnosed with gastrointestinal stromal tumors(GIST). Methods Clinical data of 78 patients with GIST receiving surgical treatment in the Third Affiliated Hospital of Sun Yat-sen University from 2003 to 2013 were retrospectively analyzed. All patients were divided into the low NLR/RDW groups(NLR ≤ 3.85, RDW ≤ 0.142) and high NLR/RDW groups(NLR > 3.85, RDW > 0.142) according to the values of NLR and RDW. Clinicopathological factors between two groups were statistically compared followed by survival analysis. Results Preoperative NLR and RDW values were significantly correlated with tumor size, mitotic count, risk ranking and distant metastasis(all P<0.05). The 5-year survival rate in the low NLR group was remarkably higher than that in the high NLR group(91.3% vs. 0%;χ^2=74.805, P<0.05). The 5-year survival rate in the low RDW group was significantly higher compared with that in the high RDW group(76.8% vs. 29.1%;χ^2=13.109, P<0.05), respectively. Multivariate analysis demonstrated that tumor size(HR=3.568, 95%CI=1.414-9.001), mitotic count(HR=8.321, 95%CI 1.515-45.684), NLR(HR=35.254, 95%CI 6.522-190.558) and RDW(HR=2.072, 95%CI 1.141-3.761) were the independent risk factors of clinical prognosis of GIST patients(all P<0.05). Conclusion Preoperative NLR and RDW can be adopted to predict and evaluate the clinical prognosis of patients with GIST.

关 键 词：胃肠道间质瘤 中性粒细胞淋巴细胞比率 红细胞分布宽度 预后 

分 类 号：R735[医药卫生—肿瘤]