胃癌外周血淋巴细胞数关联因素的横断面研究  

Associated factors of peripheral blood lymphocyte counts in gastric cancer:a cross-sectional study

作　　者：汪圣毅[1] 周浩 刘虎[3] Wang Shengyi;Zhou Hao;Liu Hu(Dept of General Surgery,The First Affiliated Hospital of Anhui Medical University,Hefei 230022;Dept of Surgery,901th Hospital of the Chinese People′s Liberation Army Joint Logistics Support Force,Hefei 230031;Dept of Oncology,West District of The First Affiliated Hospital of University of Science and Technology of China,Hefei 230031)

机构地区：[1]安徽医科大学第一附属医院普外科,合肥230022 [2]中国人民解放军联勤保障部队第901医院外科,合肥230031 [3]中国科学技术大学附属第一医院西区(安徽省肿瘤医院)肿瘤内科,合肥230031

出　　处：《安徽医科大学学报》2023年第1期151-155,共5页Acta Universitatis Medicinalis Anhui

基　　金：国家自然科学基金(编号:81472750)。

摘　　要：目的识别胃癌患者外周血淋巴细胞数(PBLC)的关联因素。方法横断面设计,收集行胃癌手术的患者资料,用单因素分析、多元线性回归、变量重要性评价,分析术前PBLC变化的关联因素。局部加权回归和稳健线性模型进一步验证。结果术前PBLC<1.1×10^(9)/L(A组)138例(20.72%),PBLC≥1.1×10^(9)/L(B组)528例(79.28%)。相对于B组,A组的年龄较大[(64.61±10.42)岁vs(62.18±10.41)岁,P<0.05],中性粒细胞较低[(3.21±1.41)×10^(9)/L vs(3.59±1.31)×10^(9)/L,P<0.01]。淋巴细胞减少与较高的胃癌分期有关,P<0.01。多元线性回归分析显示模型残差随机分布,年龄(β=-0.01,t=-3.70,P<0.01)、肿瘤分期[β(ⅡvsⅠ)=-0.16,t=-2.79,P<0.01;β(ⅢvsⅠ)=-0.18,t=-3.87,P<0.01;β(ⅣvsⅠ)=-0.21,t=-2.16,P<0.05]是淋巴细胞减少的关联因素,中性粒细胞增加与PBLC升高有关(β=0.05,t=3.61,P<0.01)。连续自变量的相对重要性分析显示,年龄、中性粒细胞、癌胚抗原(CEA)的LMG指标分别为55.55%、44.14%、0.31%。局部加权回归和稳健线性模型显示,年龄是PBLC的负向关联因素。结论胃癌PBLC与中性粒细胞正向关联。Objective To identify the associated factors of peripheral blood lymphocyte counts(PBLC)in gastric cancer patients.Methods In this cross-sectional study,data were collected from patients underwent gastric cancer surgery.Univariate analysis,multiple linear regression and variable importance metrics were used to assess factors associating PBLC in pre-operative patients.The findings were further investigated by fitting locally weighted regression(loess)and robust linear model(rlm).Results Patients with pre-operative PBLC<1.1×10^(9)/L(group A)were 138(20.72%),whereas patients with PBLC≥1.1×10^(9)/L(group B)were 528(79.28%).Compared to group B,patients in group A were older[(64.61±10.42 years)vs(62.18±10.41 years),P<0.05]and showed lower neutrophils[(3.21±1.41)×10^(9)/L vs(3.59±1.31)×10^(9)/L,P<0.01].Lymphopenia was associated with later stage of gastric cancer,P<0.01.A multiple linear regression model with randomly distributed residuals found that age(β=-0.01,t=-3.70,P<0.01)and tumor stage[β(ⅡvsⅠ)=-0.16,t=-2.79,P<0.01;β(ⅢvsⅠ)=-0.18,t=-3.86,P<0.01;β(ⅣvsⅠ)=-0.21,t=-2.16,P<0.05]were to be statistically significant factors for lymphopenia.Neutrophil increase(β=0.05,t=3.61,P<0.01)was associated with a higher PBLC.The relative importance analysis for continuous independent variables showed that relative importance metric LMGs in variable age,neutrophil and CEA were 55.55%,44.14%and 0.31%respectively.Loess and rlm models showed that age was the negatively influencing factor of PBLC.Conclusion PBLC in gastric cancer patients were positively associated with neutrophils,and negatively associated with age and tumor stages.

关 键 词：胃肿瘤 外周血淋巴细胞数 多元线性回归 横断面研究 局部加权回归 稳健线性模型 TNM分期 

分 类 号：R735.2[医药卫生—肿瘤] R730.3[医药卫生—临床医学]