外周血血小板与淋巴细胞比值(PLR)评估新辅助化疗胃癌患者预后的相关研究  

A study on the evaluation of the prognosis of gastric cancer patients with neoadjuvant chemotherapy by peripheral blood platelet-to-lymphocyte ratio

作　　者：范立奎 李磊 范少鹏 赵洪乾 FAN Likui;LI Lei;FAN Shaopeng;ZHAO Hongqian(Department of General Surgery,Gaomi City Hospital of Traditional Chinese Medicine,Gaomi,Shandong 261500,China;Department of Orthopedics,Gaomi City Hospital of Traditional Chinese Medicine,Gaomi,Shandong 261500,China)

机构地区：[1]高密市中医院普通外科,山东潍坊261500 [2]高密市中医院骨一科,山东潍坊261500

出　　处：《国际检验医学杂志》2023年第S02期145-151,共7页International Journal of Laboratory Medicine

摘　　要：目的探究外周血血小板与淋巴细胞比值(PLR)评估新辅助化疗胃癌患者预后的相关研究,以期为临床上胃癌患者的治疗方案的选择提供理论依据。方法本研究收集自2020年1月至2022年1月收治该院普通外科收治的297例胃癌患者为研究对象,所有患者均经过病理诊断为胃腺癌,均采用新辅助治疗后行根治性切除术,收集患者的一般基准资料,包括性别,年龄,身高,体质量,是否患有高血压、糖尿病和冠心病等,收集患者的临床病理学资料,包括肿瘤最大径,是否有癌栓,是否神经浸润,TNM分期等。利用受试者工作(ROC)曲线确定胃癌化疗前外周血小板与淋巴细胞比值(PLR)的临界值,根据临界值进行分组,分成升高组和降低组。生存率的计算采用Kaplan-Meier法,与胃癌化疗预后相关的单因素分析和多因素分析均采用COX比例风险回归模型。结果根据PLR的计算值绘制ROC曲线下面积为0.903(95%CI:0.551~0.643),当PLR=142时,约登指数处于最高值,因此,本研究以PLR=142作为临界点,计算其灵敏度为94.1%,特异度为95.3%。其中升高组患者109例,降低组患者188例。利用Kaplan-Meier绘制生存曲线,结果显示,降低组患者5年生存率(OS)为92.1%,升高组患者5年OS为67.4%,降低组患者5年无进展生存期(PFS)为93.1%,升高组患者5年PFS为71.2%;单因素分析结果和多因素分析结果显示,年龄(是否高龄),肿瘤最大径(是否≥5 cm),TNM分期,有无术后辅助化疗,癌栓(有/无),神经侵入(有/无),病理反应和PLR差值是与胃癌患者OS和PFS相关的高危因素(P<0.05)。结论外周血中性粒细胞与淋巴细胞比值(NLR)可以预测胃癌新辅助化疗方案的预后效果。Objective To explore the correlation between peripheral blood platelet-to-lymphocyte ratio(PLR)and the prognosis of gastric cancer patients receiving neoadjuvant chemotherapy,in order to provide a theoretical basis for the selection of treatment plans for gastric cancer patients in clinical practice.Methods This study included 297 patients with gastric adenocarcinoma who underwent radical resection after neoadjuvant therapy at Gaomi City Hospital of Traditional Chinese Medicine from January 2020 to January 2022.The general baseline data of the patients were collected,including gender,age,height,weight,and comorbidities such as hypertension,diabetes,and coronary heart disease.Clinical pathological data of the patients were also collected,including tumor size,presence of cancer emboli,nerve invasion,TNM staging,etc.The critical value of PLR before gastric cancer chemotherapy was determined using the receiver operating characteristic(ROC)curve,and the patients were divided into high and low PLR groups according to the critical value.Kaplan-Meier method was used to calculate survival rates,and single-factor and multi-factor analyses related to the prognosis of gastric cancer chemotherapy were performed using the Cox proportional hazards regression model.Results The area under the ROC curve of PLR was 0.903(95%CI:0.551-0.643).When PLR=142,the Youden′s index reached the maximum value,with a sensitivity of 94.1%and specificity of 95.3%.Among the patients,109 were classified into the high PLR group and 188 were classified into the low PLR group.Kaplan-Meier survival curves showed that the 5-year overall survival(OS)rate of the low PLR group was 92.1%,while that of the high PLR group was 67.4%;the 5-year progression-free survival(PFS)rate of the low PLR group was 93.1%,while that of the high PLR group was 71.2%.Single-factor and multi-factor analyses showed that age(elderly or not),tumor size(≥5 cm or not),TNM stage,postoperative adjuvant therapy,cancer emboli(yes or no),nerve invasion(yes or no),pathological response

关 键 词：胃癌 新辅助化疗 血小板与淋巴细胞比值 预测 

分 类 号：R735.2[医药卫生—肿瘤]