术前NLR、MLR、PLR和SⅡ检测在判断胃癌淋巴结转移中的应用价值  

The Value of Preoperative NLR,MLR,PLR and SⅡin the Diagnosis of Lymph Node Metastasis of Gastric Cancer

作　　者：章晓燕 张光满[1] ZHANG Xiao-yan;ZHANG Guang-man(Department of Clinical Laboratory,the Second People`s Hospital of Lu`an,Lu`an,Anhui 237008)

机构地区：[1]皖西卫生职业学院附属医院检验科,237008

出　　处：《临床输血与检验》2021年第6期783-787,共5页Journal of Clinical Transfusion and Laboratory Medicine

摘　　要：目的分析中性粒细胞与淋巴细胞比值(NLR)、单核细胞与淋巴细胞比值(MLR)、血小板与淋巴细胞比值(PLR)、系统性免疫性炎症指数(SⅡ)在胃癌淋巴结转移诊断中的应用价值。方法选取2017年1月~2019年12月在本院进行胃癌筛查的98例患者,根据病理诊断结果分为胃癌组61例和胃良性病变组37例,其中胃癌组又根据有无淋巴结转移分为淋巴结转移组35例和无淋巴结转移组26例。根据患者术前血常规检测结果分别计算NLR、MLR、PLR和SⅡ,并分析各指标在胃癌淋巴结转移中的诊断效能。结果61例胃癌患者中发生淋巴结转移的患者共35例,转移率为57.38%。淋巴结转移组的NLR、MLR、PLR和SⅡ水平均显著高于无淋巴结转移组和胃良性病变组(P<0.01)。NLR、MLR、PLR和SⅡ诊断胃癌淋巴结转移ROC曲线下面积分别为0.761、0.708、0.686和0.781,诊断临界值分别为3.23、0.29、197.70、574.47。NLR、MLR、PLR和SⅡ均与肿瘤的分化、浸润、直径和分期相关,分化低、浸润深、直径大和分期高的患者四参数值更高(P<0.05),四参数在不同性别、年龄和肿瘤位置的比较无统计学差异(P>0.05)。结论NLR、MLR、PLR和SⅡ与胃癌的分化、浸润、直径、分期和淋巴节转移相关,可以辅助诊断胃癌淋巴结转移,为选择胃癌手术方式和确定淋巴结清扫范围提供参考。Objective To investigate the value of the ratio of neutrophil to lymphocyte(NLR),monocyte to lymphocyte(MLR),platelet to lymphocyte(PLR),and systemic immune inflammatory index(SⅡ)in the diagnosis of lymph node metastasis of gastric cancer.Methods A total of 98 patients,which were screened for gastric cancer in our hospital from January 2017 to December 2019,were divided into gastric cancer group(61 cases)and gastric benign disease group(37 cases)by pathological diagnosis.According to the lymph node metastasis,gastric cancer group was further divided into lymph node metastasis group(35 cases)and non lymph node metastasis group(26 cases).NLR,MLR,PLR and SⅡwere calculated according to the results of preoperative blood routine test,and the efficiency of each index in the diagnosis of lymph node metastasis was analyzed.Results Among 61 cases of gastric cancer,35 cases had lymph node metastasis,the metastasis rate was 57.38%.The levels of NLR,MLR,PLR and SⅡin lymph node metastasis group were significantly higher than those in non lymph node metastasis group and gastric benign disease group(P<0.01).The area under ROC curve of NLR,MLR,PLR and SⅡwas 0.761,0.708,0.686 and 0.781,respectively.The critical values of NLR,MLR,PLR and SⅡwere 3.23,0.29,197.7 and 574.47,respectively.NLR,MLR,PLR and SⅡwere correlated with tumor differentiation,invasion,diameter and stage.Patients with lower differentiation,deeper invasion,larger diameter and higher stage had higher values of NLR,MLR,PLR and SⅡ(P<0.05).There was no significant difference in NLR,MLR,PLR and SⅡ(P>0.05)with tumor location.Conclusion NLR,MLR,PLR and SⅡare related to the differentiation,invasion,diameter and stage of gastric cancer,which could be helpful for the diagnosis of lymph node metastasis of gastric cancer,and provide a reference for the choice of surgical methods and the scope of lymph node dissection.

关 键 词：胃癌 淋巴结转移 中性粒细胞与淋巴细胞比值 单核细胞与淋巴细胞比值 血小板与淋巴细胞比值 系 统性免疫炎症指数 

分 类 号：R735.2[医药卫生—肿瘤]