外周血中性粒细胞/淋巴细胞比值与进展期胃癌患者新辅助化疗效果及预后的相关性分析  

Correlation analysis between neutrophil/lymphocyte ratio of peripheral blood inflammatory index and the effect and prognosis of neoadjuvant chemotherapy in patients with advanced gastric cancer

作　　者：姜兆志 禚志明 汤小龙 侯振宇 曲辉[1] JIANG Zhao-zhi;ZHUO Zhi-ming;TANG Xiao-long;HOU Zhen-yu;QU Hui(Department of General Surgery,Qilu Hospital of Shandong University,Jinan 250012,China;Department of General Surgery,Longkou People's Hospital,Longkou 265701,China)

机构地区：[1]山东大学齐鲁医院普外科,山东济南250012 [2]龙口市人民医院普外科,山东龙口265701

出　　处：《中国现代普通外科进展》2023年第10期787-792,共6页Chinese Journal of Current Advances in General Surgery

摘　　要：目的:探讨中性粒细胞/淋巴细胞比值(NLR)与进展期胃癌患者新辅助化疗(NAC)预后的相关性。方法:回顾性分析2016年8月至2019年8月的135例于山东大学齐鲁医院接受NAC后行根治性手术的进展期胃癌患者病例资料;根据NAC前后NLR的变化将患者分为NLR升高组和降低组,进一步根据NAC后NLR的中位数(1.69)将上述两组划分为4个亚组:NLR≥1.69+升高;NLR≥1.69+降低;NLR<1.69+升高和NLR<1.69+降低。分析各组患者临床病理参数特征、3年总生存率和无疾病生存率的关系。Cox比例风险模型分析患者OS和DFS的预后因素。结果:NLR降低组的NAC后NLR<1.69患者例数和存活率显著高于NLR升高组;NLR降低组NAC有效率(CR+PR)显著高于NLR升高组。Cox回归分析表明肿瘤低分化、发生转移和NLR升高是影响进展期胃癌患者OS和DFS的独立危险因素。生存曲线结果表明NLR降低组及NAC后NLR<1.69组的OS和DFS显著高于NLR升高组及NAC后NLR≥1.69组;亚组分析的生存曲线结果表明NLR<1.69+NLR降低组预后最好,NLR≥1.69+NLR升高组预后最差。结论:NAC后外周血NLR降低提示进展期胃癌患者NAC效果和预后好。Objective:Explore the correlation between the NLR and the prognosis of advanced gastric cancer patients receiving NAC.Methods:Retrospective analysis of 135 advanced gastric cancer patients who received curative surgery after NAC at Shandong University Qilu Hospital(Aug 2016~Aug 2019).Based on NLR changes pre and post-NAC,patients were divided into NLR elevation and reduction groups.Subsequently,using the median NLR post-NAC(1.69),these groups were subdivided into:NLR≥1.69+elevation;NLR≥1.69+reduction;NLR<1.69+elevation;and NLR<1.69+reduction.Associations between clinical factors,3-year OS rate,DFS rate,and groups were analyzed.Cox proportional hazards model assessed OS and DFS prognostic factors.Results:NLR<1.69 post-NAC had higher patient count and survival rate compared to NLR increase(P<0.001).NLR decrease group showed significantly higher NAC effectiveness(CR+PR)(P<0.001).Cox regression revealed poor differentiation,metastasis,and higher NLR as independent OS and DFS risk factors.Survival curve data indicated NLR decrease and NLR<1.69 post-NAC had superior OS and DFS to NLR increase and NLR≥1.69 post-NAC.NLR<1.69+NLR decrease had the best prognosis;NLR≥1.69+NLR increase exhibited the worst(P<0.05).Conclusion:Decreased peripheral blood NLR after NAC suggests a favorable effect and prognosis for patients with advanced gastric cancer.

关 键 词：胃肿瘤 进展期 中性粒细胞/淋巴细胞比值 新辅助化疗 预后 

分 类 号：R735.2[医药卫生—肿瘤]