手术前后血小板与淋巴细胞比值变化对胃癌预后的评估价值  

Assessment value of platelet to lymphocyte ratio changes before and after surgery in the prognosis of gastric cancer

作　　者：郑强 赖佳敏 刘旭东 杜鹏 赵斌[1] 程志斌[1] ZHENG Qiang;LAI Jiamin;LIU Xudong;DU Peng;ZHAO Bin;CHENG Zhibin(Department of General Surgery,Lanzhou University Second Hospital,Lanzhou,Gansu 730030,China)

机构地区：[1]兰州大学第二医院普通外科,730030

出　　处：《重庆医学》2023年第11期1639-1644,共6页Chongqing medicine

基　　金：国家自然科学基金项目(82060508)。

摘　　要：目的探讨手术前后血小板与淋巴细胞比值(PLR)变化对胃癌预后的评估价值。方法收集2016年12月到2017年7月于兰州大学第二医院普外科收治的208例胃癌患者临床病理资料。并根据其各自ROC曲线的最佳截断值,将其分为术前升高组/降低组及术后升高组/降低组。分析手术前后各组胃癌患者的临床病理特征和预后的关系。结果术前PLR与侵犯深度、淋巴结转移、肿瘤大小有关,且术前PLR升高组在侵犯深度为T_(3~4)、伴淋巴结转移、>5 cm肿瘤的患者中所占比例高于术前PLR降低组(P<0.05)。术后PLR升高组与降低组在临床病理特征方面无明显差异。生存分析显示,术前PLR升高组5年生存率低于术前PLR降低组,术后PLR升高组的5年生存率低于术后PLR降低组,将术前PLR与术后PLR联合分析,结果显示手术前后PLR均升高组5年生存率最低,手术前后PLR均降低组5年生存率最高。多因素分析影响胃癌预后因素,结果显示手术前后PLR均升高、全胃切除、伴淋巴结转移和神经侵犯是影响胃癌预后的独立危险因素。结论联合检测手术前后PLR水平有助于判断胃癌预后,且手术前后PLR均升高的胃癌患者预后较差。Objective To explore the assessment value of platelet to lymphocyte ratio(PLR)changes before and after surgery in the prognosis of gastric cancer.Methods The clinicopathological data of 208 patients with gastric cancer admitted to the Department of General Surgery of Lanzhou University Second Hospital from December 2016 to July 2017 were collected.According to the best truncation value of their respective receiver operating characteristic(ROC)curves,they were divided into the preoperative increase group/decrease group and the postoperative increase group/decrease group.The relationship between the clinicopathological data and prognosis of gastric cancer patients in each group before and after operation were analyzed.Results Preoperative PLR was related to invasion depth,lymph node metastasis and tumor size,and the proportion of patients with invasion depth of T_(3)-T_(4),lymph node metastasis and tumor>5 cm in the group with increased PLR before operation was higher than that in the group with decreased PLR before operation(P<0.05).There was no significant difference in the clinicopathological characteristics between the PLR increased group and the PLR decreased group after operation.The survival analysis showed that the five-year survival rate of the group with increased PLR before operation was lower than that of the group with decreased PLR before operation,and the five-year survival rate of the group with increased PLR after operation was lower than that of the group with decreased PLR after operation.The combined analysis of preoperative PLR and postoperative PLR showed that the five-year survival rate of the group with increased PLR before and after operation was the lowest,and the five-year survival rate of the group with decreased PLR before and after operation was the highest.The multivariate analysis showed that increased PLR before and after operation,total gastrectomy,lymph node metastasis and nerve invasion were independent risk factors for the prognosis of gastr ic cancer.Conclusion Combined detecti

关 键 词：胃癌 血小板与淋巴细胞比值 预后 评估价值 

分 类 号：R735.2[医药卫生—肿瘤]