术前红细胞平均血红蛋白浓度联合中性粒细胞-淋巴细胞比值与胃癌手术切除患者预后的关系  

Combining the mean corpuscular hemoglobin concentration and neutrophil-to-lymphocyte ratio predicts the survial in patients after gastrectomy gastric cancer

作　　者：李国兴[1] 李静[2] 张珣磊 江晓晖[1] 张陈霏 赵文静[2] LI Guoxing;LI Jing;ZHANG Xunlei;JIANG Xiaohui;ZHANG Chenfei;ZHAO Wenjing(Department of Surgery,Nantong Tumor Hospital,Jiangsu Province&Tumor Hospital Affiliated to Nantong University,Nantong 226361;Cancer Research Center Nantong,Nantong Tumor Hospital,Jiangsu Province&Tumor Hospital Affiliated to Nantong University,Nantong 226361;Department of Oncology,Nantong Tumor Hospital,Jiangsu Province&Tumor Hospital Affiliated to Nantong University,Nantong 226361)

机构地区：[1]江苏省南通市肿瘤医院,南通大学附属肿瘤医院胃肠外科,南通226361 [2]江苏省南通市肿瘤医院,南通大学附属肿瘤医院肿瘤研究所,南通226361 [3]江苏省南通市肿瘤医院,南通大学附属肿瘤医院肿瘤内科,南通226361

出　　处：《南通大学学报（医学版）》2022年第1期5-10,共6页Journal of Nantong University(Medical sciences)

基　　金：南通市市级科技计划项目(JCZ19041,MS22019008);南通市卫生与健康委员会科研课题专项(QA2020018,MB2020022);南通大学临床医学专项(2019JQ013)。

摘　　要：目的:评估术前外周血红细胞平均血红蛋白浓度(mean corpuscular hemoglobin concentration,MCHC)和全身炎症反应标志物中性粒细胞-淋巴细胞比值(neutrophil-to-lymphocyte ratio,NLR)与胃癌手术切除患者预后的关系。方法:回顾性分析2007—2013年间确诊的182例胃癌患者,根据受试者工作特征(receiver operating characteristic,ROC)曲线分析和约登指数确定胃癌手术患者MCHC和NLR最佳临界值,分为MCHC>339.5 g/L组和MCHC≤339.5 g/L组;NLR>2.619组和NLR≤2.619组。根据MCHC-NLR联合评分(0,1,2)将队列分成3组。χ^(2)检验分析MCHC和NLR与临床病理特征间的关系,Kaplan-Meier法评估MCHC、NLR以及MCHC-NLR与患者预后的关系,Cox单因素和多因素回归分析总生存期(overall survival,OS)和无疾病生存期(disease-free survival,DFS)的危险因素。结果:高MCHC组和高NLR组OS和DFS均较低(均P<0.001),MCHC-NLR评分为2分的患者OS和DFS预后较差。多变量分析显示,MCHC-NLR和TNM分期是胃癌手术切除患者OS和DFS的独立预后因素。结论:高水平MCHC和高NLR胃癌患者OS和DFS较差,MCHC-NLR是独立不良预后因素,对预测胃癌患者的生存率和指导临床治疗有一定的临床意义。Objective:To evaluate the association between preoperative mean corpuscular hemoglobin concentration(MCHC)and systemic inflammatory response marker neutrophil-to-lymphocyte ratio(NLR)with prognosis of gastric cancer(GC)patients undergoing surgical resection.Methods:A total of 182 patients with GC,diagnosed between 2007 and 2013 were enrolled.Receiver operating characteristic(ROC)curves analysis were used to confirm the cut-off value,and patients were stratified into MCHC>339.5 g/L and MCHC≤339.5 g/L groups;NLR>2.619 and NLR≤2.619 groups.Base on the criteria of MCHC-NLR score(0,1,2),all patients were divided into three group.The relationship between MCHC,NLR and clinicopathological characters was analyzed by χ^(2) test,prognosis was assessed by Kaplan-Meier survival curve.The risk factors of overall survival(OS)and disease-free survival(DFS)were analyzed by Cox Univariate and multivariate analyses.Results:Both high MCHC and NLR group had lower OS and DFS(all P<0.001).Patients with MCHC-NLR score of 2 had the worst prognose of OS and DFS.Multivariate analyses revealed that MCHC-NLR and TNM were an independent prognostic factor for OS and PFS in patients with GC.Conclusion:Patients with co-high level of pretreatment MCHC and NLR indicate unfavourable OS and DFS,the findings contribute to better predict patients survival and clinical therapy for GC patients.

关 键 词：胃癌 红细胞平均血红蛋白浓度 中性粒细胞-淋巴细胞比值 手术切除 预后 

分 类 号：R735.2[医药卫生—肿瘤]