中性粒细胞与淋巴细胞的比值与胃癌患者预后的关系
发布时间：2018-10-18 18:06
【摘要】：目的:探讨术前中性粒细胞与淋巴细胞比值(Neutrophil-lymphocyte ratio,NLR)在评估胃癌患者预后的临床价值和意义,指导胃癌术后的治疗。方法:选取2010年1月至2011年12月就诊于福建医科大学附属第一医院经病理学确诊为胃癌的94例患者,并且患者的病例资料、随访资料完整,作为本文的回顾性研究对象。收集入选患者的临床病理资料包括年龄、性别、肿瘤浸润深度、淋巴结转移数目、肿瘤TNM分期、肿瘤大小、肿瘤分化程度等;另外选取患者术前一周内的一次血常规,记录中性粒细胞与淋巴细胞的比值,即术前NLR值。通过构建ROC曲线截取NLR=2.24为其最佳临界值,将患者分为高NLR组和低NLR组。分析患者各临床病理因素与术前NLR之间的关系;单因素分析和COX回归分析判断术前NLR是否为胃癌患者预后的影响因素及独立危险因素。结果:在94例病例中,男性患者69例,占73%,术前NLR均数为2.49±1.37;女性患者25例,占27%,术前NLR均数为2.49±1.17。年龄≥65岁患者34例,术前NLR均数为2.48±1.13;年龄65岁患者60例,术前NLR均数为2.50±1.42。肿瘤大小≥4cm的患者53例,肿瘤大小4cm的患者有41例。肿瘤浸润深度T1+T2和T3+T4的患者分别有26例和68例。淋巴结转移中:N0+N1和N2+N3的患者分别有49例、45例。TNM中I期+II期和III期患者分别为44例、50例。中-高分化患者28例,术前NLR均数为2.61±1.92;低分化患者66例,术前NLR均数为2.44±1.00。术前低NLR组(NLR2.24)和高NLR组(NLR≥2.24)的5年生存率分别为69%和30%。术前低NLR组(NLR2.24)的患者生存率明显优于高NLR组(NLR≥2.24),即高NLR组患者预后比低NLR组预后差,差异具有统计学意义(P=0.000)。COX回归分析提示,术前NLR可成为单独影响胃癌患者预后的简单临床因素;此外,淋巴结转移数目、肿瘤TNM分期、肿瘤大小、肿瘤浸润深度等可影响胃癌患者预后。结论:1.术前NLR是影响胃癌患者预后的重要因素,术前NLR≥2.24的胃癌患者预后显著差于NLR2.24的胃癌患者。2.术前NLR与患者的肿瘤浸润深度、淋巴结转移数目、肿瘤TNM分期显著相关,与患者年龄、性别、肿瘤大小、肿瘤分化程度无关。3.由单、多因素分析得出术前NLR是胃癌患者预后的独立危险因素。
[Abstract]:Objective: to evaluate the clinical value and significance of preoperative neutrophil / lymphocyte ratio (Neutrophil-lymphocyte ratio,NLR) in evaluating the prognosis of gastric cancer patients. Methods: from January 2010 to December 2011, 94 patients with gastric cancer diagnosed pathologically in the first affiliated Hospital of Fujian Medical University were selected and followed up data were complete. The clinicopathological data of the patients included age, sex, depth of tumor invasion, number of lymph node metastasis, TNM stage, tumor size, degree of tumor differentiation and so on. The ratio of neutrophils to lymphocytes was recorded, i.e. the preoperative NLR value. The patients were divided into high NLR group and low NLR group by constructing ROC curve to intercept NLR=2.24 as its best critical value. The relationship between clinicopathological factors and preoperative NLR was analyzed, and univariate analysis and COX regression analysis were used to determine whether preoperative NLR was the prognostic factor and independent risk factor of gastric cancer. Results: among 94 cases, 69 cases were male (73%), the mean of NLR was 2.49 卤1.37 before operation, 25 cases (27.7%) of female patients, the mean of preoperative NLR was 2.49 卤1.17 (P < 0.05). The mean preoperative NLR was 2.48 卤1.13 in 34 patients aged 鈮，
本文编号：2279947
[Abstract]:Objective: to evaluate the clinical value and significance of preoperative neutrophil / lymphocyte ratio (Neutrophil-lymphocyte ratio,NLR) in evaluating the prognosis of gastric cancer patients. Methods: from January 2010 to December 2011, 94 patients with gastric cancer diagnosed pathologically in the first affiliated Hospital of Fujian Medical University were selected and followed up data were complete. The clinicopathological data of the patients included age, sex, depth of tumor invasion, number of lymph node metastasis, TNM stage, tumor size, degree of tumor differentiation and so on. The ratio of neutrophils to lymphocytes was recorded, i.e. the preoperative NLR value. The patients were divided into high NLR group and low NLR group by constructing ROC curve to intercept NLR=2.24 as its best critical value. The relationship between clinicopathological factors and preoperative NLR was analyzed, and univariate analysis and COX regression analysis were used to determine whether preoperative NLR was the prognostic factor and independent risk factor of gastric cancer. Results: among 94 cases, 69 cases were male (73%), the mean of NLR was 2.49 卤1.37 before operation, 25 cases (27.7%) of female patients, the mean of preoperative NLR was 2.49 卤1.17 (P < 0.05). The mean preoperative NLR was 2.48 卤1.13 in 34 patients aged 鈮，
本文编号：2279947
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