术前血清纤维蛋白原与淋巴细胞比值与胃癌患者预后关系的研究  

Relationship Between Preoperative Serum Fibrinogen to Lymphocyte Ratio And Prognosis in Patients With Gastric Cancer

作　　者：汪杰 汪强武[1] 郑海伦[1] 许明涛 刘周琳 王启之[1] WANG Jie;WANG Qiang-wu;ZHENG Hai-lun;XU Ming-tao;LIU Zhou-lin;WANG Qi-zhi(Department of Gastroenterology,The First Affiliated Hospital of Bengbu Medical College,Bengbu,Anhui,233000)

机构地区：[1]蚌埠医学院第一附属医院消化科,233000

出　　处：《现代消化及介入诊疗》2023年第4期415-420,共6页Modern Interventional Diagnosis and Treatment in Gastroenterology

基　　金：安徽省高等学校自然科学类重大项目(2022AH040216);蚌埠医学院512人才培育计划项目(by51201216);蚌埠医学院自然科学重点项目(2020byzd092)。

摘　　要：目的判断术前纤维蛋白原与淋巴细胞比值(FLR)是否为胃癌患者的预后因素,并分析胃癌患者术前FLR与临床病理特征的关系。方法回顾性收集于2016.01~2018.12在蚌埠医学院第一附属医院行胃癌手术患者301例,其中资料完整,预后记录明确患者263例,研究患者术前FLR与临床病理特征及预后的关系。结果FLR预测病人结局曲线下面积AUC为0.846,P<0.05,差异有统计学意义。计算约登指数,约登指数最大值为0.627,此时对应的最佳截断值为2.17,据此将FLR分为两组,FLR≥2.17为FLR升高组,共129例;FLR<2.17为FLR降低组,共134例。单因素COX及多因素回归分析显示,年龄、肿瘤分化程度、TNM分期、术前FLR值是影响胃癌患者总生存期(overall survival,OS)的独立危险因素,年龄、肿瘤分化程度、术前FLR值是影响胃癌患者无进展生存期(progression free survival,PFS)的独立危险因素。(P值均<0.05)。亚组分析显示,Ⅰ~Ⅱ和Ⅲ期胃癌患者中,在无淋巴结转移和有淋巴结转移的患者中,低水平的FLR组患者的预后明显好于高水平组患者。结论术前FLR是影响胃癌患者预后的独立危险因素。本研究为其用于预测胃癌手术患者的预后提供了临床依据。Objective To determine whether preoperative fibrinogen to lymphocyte ratio(FLR)is a prognostic factor in patients with gastric cancer,and to analyze the relationship between preoperative FLR and clinicopathological features in patients with gastric cancer.Methods A total of 301 patients who underwent surgery for gastric cancer in the First Affiliated Hospital of Bengbu Medical College from January 2016 to December 2016 were retrospectively collected,including 263 patients with complete data and definite prognosis records.The relationship between preoperative FLR and clinicpathological features and prognosis of patients was studied.Results The area AUC under the outcome curve predicted by FLR was 0.846,P<0.05,and the difference was statistically significant.The maximum value of Yoden index was 0.627,and the optimal cutoff value was 2.17.FLR was divided into two groups,FLR≥2.17 was the increased FLR group,129 cases in total.FLR<2.17 was the lower FLR group,134 cases in total.Univariate COX and multivariate regression analysis showed that age,tumor differentiation,TNM stage and preoperative FLR value were independent risk factors affecting Overall Surviva(OS)in patients with gastric cancer.Age,degree of tumor differentiation and preoperative FLR value are independent risk factors affecting Progression Free Survival(PFS)of patients with gastric cancer.(All P values were<0.05).Subgroup analysis showed that in stageⅠ~ⅡandⅢgastric cancer patients,the prognosis of patients with low level of FLR was significantly better than that of patients with high level of FLR in patients without and with lymph node metastasis.Conclusion Preoperative FLR is an independent risk factor for the prognosis of patients with gastric cancer.This study provides a clinical basis for predicting the prognosis of patients with gastric cancer undergoing surgery.

关 键 词：胃癌 纤维蛋白原与淋巴细胞比值 预后 

分 类 号：R735.2[医药卫生—肿瘤] R573[医药卫生—临床医学]