胃癌患者术前血常规水平与远期生存相关性  

Correlation Analysis of Preoperative Blood Routine Level and Long-term Survival in Gastric Cancer Patients

作　　者：董晨雨 南京柱 张佳琪 张旭[1] DONG Chenyu;NAN Jingzhu;ZHANG Jiaqi;ZHANG Xu(First Medical Center,General Hospital of the People’s Liberation Army,Beijing 100853,China;Sinopharm First Hospital,Baotou 014030,China;Beijing Anzhen Hospital,Capital Medical University,Beijing 100029,China;The First Clinical Medical College of Ningxia Medical University,Yinchuan 750004,China)

机构地区：[1]解放军总医院第一医学中心,北京100853 [2]国药一机医院,内蒙古包头014030 [3]首都医科大学附属北京安贞医院,北京100029 [4]宁夏医科大学第一临床医学院,宁夏银川750004

出　　处：《北华大学学报（自然科学版）》2024年第5期653-659,共7页Journal of Beihua University（Natural Science）

基　　金：科技部国家重点研发计划项目(2021YFC1005300)。

摘　　要：目的探讨血常规中红细胞(RBC)、血红蛋白(HGB)、血细胞比容(HCT)、平均红细胞体积(MCV)、平均红细胞血红蛋白(MCH)、平均红细胞血红蛋白浓度(MCHC)不同水平与胃癌患者远期生存的相关性。方法收集95例胃癌患者临床资料,统计不同生存时间指标差异,制作二元Logistic回归模型,绘制ROC曲线,分析胃癌患者远期生存的危险因素。结果不同分化程度、Lauren分型、TNM分期、Borrmann分型、肿瘤大小在患者生存期≥3 a组和<3 a组间比较差异具有统计学意义(P<0.001、0.004、<0.001、0.010、<0.001)。RBC、HGB、HCT、MCV、MCH、MCHC水平生存期≥3 a组显著高于<3 a组(P=0.003、0.009、0.003、0.032),将其代入二元Logistic回归模型,得出RBC、MCV、MCH、MCHC差异具有统计学意义(P=0.091、0.007、0.025、0.012)。ROC曲线显示,RBC、MCHC水平对胃癌患者3 a生存预测具有统计学意义(P=0.009、0.033),其中灵敏度分别为0.488、0.780,特异度为0.780、0.460,曲线下面积分别为0.659(0.545,0.773)、0.631(0.514,0.748)。RBC、MC V、MCH、MCHC联合检测对胃癌患者3 a生存预测敏感度为0.86,特异度为0.634,曲线下面积为0.756(0.654、0.858)。Cox单因素分析显示,HGB、RBC、HCT是影响胃癌生存预后的风险因素(P=0.004、0.005、0.002),多因素分析显示,RBC是影响胃癌生存预后的风险因素(P=0.020)。结论全血HGB、RBC、HCT、MCHC水平较高的胃癌患者远期生存较好,联合检测RBC、MCV、MCH、MCHC对胃癌患者生存预后有一定预测价值。Objective To study the correlation between different levels of each index of blood routine and long-term survival of gastric cancer patients.Method The clinical data of 95 gastric cancer patients were collected.The differences of each index at different survival times of the patients were counted,binary Logistic regression models were made,ROC curves were drawn,and the risk factors of long-term survival of gastric cancer patients were analyzed.Results The differences of different differentiation degrees,Lauren staging,TNM staging,Borrmann staging,and tumor size were statistically significant between the survival time≥3 years group and<3 years group(P<0.001,0.004,<0.001,0.010,<0.001).The levels of HGB,RBC,HCT,MCV,MCH and MCHC in the≥3 years group were significantly higher than those of the<3 year group(P=0.003,0.009,0.003,0.032).HGB,RBC,HCT,MCHC,MCV,MCH were brought into binary Logistic regression,which yielded statistically significant differences in RBC,MCV,MCH,MCHC(P=0.091,0.007,0.025,0.012).The ROC curves showed that the levels of RBC and MCHC were statistically significant in predicting the three-year survival of gastric cancer patients(P=0.009,0.033),in which the sensitivity was 0.488,0.780,the specificity was 0.780,0.460,and the area under the curve was 0.659(0.545,0.773),0.631(0.514,0.748),respectively.The combined detection of RBC,MCV,MCH,MCHC was statistically significant,with a sensitivity of 0.86,a specificity of 0.634,and an area under the curve of 0.756(0.654,0.858).Cox univariate analysis showed that HGB,RBC and HCT were the risk factors influencing the survival prognosis of gastric cancer(P=0.004,0.005,0.002),and multivariate analysis showed that RBC was the a risk factor for survival prognosis of gastric cancer(P=0.020).Conclusion The long-term survival of gastric cancer patients with higher levels of whole blood is better,and the combined detection of RBC,MCV,MCH,MCHC has a certain predictive value for the survival and prognosis of gastric cancer patients.

关 键 词：胃癌 血红蛋白 红细胞 平均红细胞血红蛋白浓度 远期生存 

分 类 号：R735[医药卫生—肿瘤]