术前中性粒细胞与淋巴细胞比值（NLR）对胃癌预后评估的价值

发布时间：2018-06-20 17:15

本文选题：胃癌 + 中性粒细胞与淋巴细胞比值　；参考：《福建中医药大学》2017年硕士论文

【摘要】：目的:研究胃癌患者术前中性粒细胞与淋巴细胞比值(Neutrophil-to-Lymphocyte Ratio,NLR)与肿瘤各预后因子之间的关系,探讨胃癌患者术前NLR对预后转归的评估价值,进而指导临床治疗。方法:选择自2013年1月至2013年12月在莆田学院附属医院行胃癌根治术治疗的122例患者病例资料进行回顾性研究,其中男90例,女32例,平均年龄60.8岁。收集患者术前中性粒细胞计数、淋巴细胞计数,根据所得数据计算患者NLR值。查阅大量海内外文献资料后,以NLR临界值为2.5,将上述合格病例分为高NLR组和低NLR组,分析NLR值与患者年纪、性别、病理类别、肿瘤大小、浸润深度、淋巴结转移、TNM分期、HER-2基因等各因子之间的关系,并对患者术后进行随访,评估NLR值对胃癌预后的临床价值。结果:1.单因素分析术前NLR值与临床各因子提示:术前NLR值高低与患者年纪、淋巴结转移、肿瘤浸润深度、TNM分期及HER-2之间差别具有统计学定见(P0.05),NLR值越高,年纪越大、淋巴结扩散的可能性越大、TNM分期越晚;HER-2阳性患者NLR值较HER-2阴性患者高。而性别、病理类别、肿瘤大小与NLR值之间无确切相关(P0.05)。进一步Logisitic多因素回归分析显示:胃癌患者年纪、浸润深度、淋巴结转移、TNM分期、HER-2与术前NLR值密切关联(P0.05)。2.肿瘤浸润深度、TNM分期、淋巴结扩散、HER-2、术前NLR值对患者术后转归有重要定见(P0.05),年纪、性别、肿瘤大小、病理分化类别与患者术后转归无确切关联(P0.05)。低NLR组患者3年存活率明显优于高NLR组病人(P=0.011),HER-2阴性患者预后好于HER-2阳性患者(P=0.02);肿瘤浸润深度越深(P=0.000)、TNM分期越晚(P=0.000)、淋巴结转移越多(P=0.006),患者3年生存率越低。结论:1.术前NLR水平可能与年纪、淋巴结扩散、肿瘤浸润深度、TNM分期及HER-2紧密相关。2.术前NLR、肿瘤浸润深度、TNM分期、淋巴结扩散可能对患者预后有重要意义。3.术前NLR或许可以成为胃癌转归的一种简便有用的评估标志物。
[Abstract]:Objective: to study the relationship between neutrophil-to-Lymphocyte Ratiophocyte NLR- (NLR-) and tumor prognostic factors in patients with gastric cancer before operation, and to explore the value of preoperative NLR in evaluating prognosis and prognosis in patients with gastric cancer, so as to guide clinical treatment. Methods: from January 2013 to December 2013, 122 patients with gastric cancer treated by radical gastrectomy in Putian University Hospital were retrospectively studied, including 90 males and 32 females, with an average age of 60.8 years. Neutrophil count and lymphocyte count were collected and NLR values were calculated. According to the critical value of NLR was 2.5, the patients were divided into high NLR group and low NLR group. The NLR value and age, sex, pathological type, tumor size, depth of invasion were analyzed. The relationship between HER-2 gene and TNM staging of lymph node metastasis was evaluated. The clinical value of NLR in the prognosis of gastric cancer was evaluated. The result is 1: 1. Univariate analysis of preoperative NLR values and clinical factors suggested that preoperative NLR values were significantly different between preoperative NLR values and patient age, lymph node metastasis, TNM stage of tumor invasion depth and HER-2. The higher the NLR value was, the higher the NLR value was and the older the patient was. The higher the probability of lymph node diffusion, the higher the NLR value in HER-2 positive patients with TNM stage. However, there was no positive correlation between sex, pathological type, tumor size and NLR value (P 0.05). Further Logisitic multivariate regression analysis showed that age, depth of invasion, lymph node metastasis, TNM staging and HER-2 were closely correlated with preoperative NLR value (P0.05. 2). TNM stage, lymph node diffusion (HER-2), preoperative NLR value were important for postoperative outcome (P0.05), age, sex, tumor size, pathological differentiation type had no definite correlation with postoperative outcome (P0.05). The 3-year survival rate of low NLR group was significantly better than that of HER-2 negative patients with high NLR, and the deeper the depth of tumor invasion was, the later the TNM stage was, the more lymph node metastasis was, the lower the 3-year survival rate was. Conclusion 1. Preoperative NLR levels may be closely related to age, lymph node diffusion, depth of tumor invasion, TNM stage and HER-2. Preoperative NLR, depth of tumor invasion and TNM stage, lymph node diffusion may have important significance for prognosis of patients. Preoperative NLR may be a simple and useful marker for evaluating the outcome of gastric cancer.
【学位授予单位】：福建中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R735.2

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