系统性炎症相关指标中性粒细胞/淋巴细胞比值及血小板/淋巴细胞比值在根治性切除术后的胃癌患者的预后意义

doi:10.11904/j.issn.1002-3070.2019.01.006

实用肿瘤学杂志 ›› 2019, Vol. 33 ›› Issue (1): 34-39.doi: 10.11904/j.issn.1002-3070.2019.01.006

系统性炎症相关指标中性粒细胞/淋巴细胞比值及血小板/淋巴细胞比值在根治性切除术后的胃癌患者的预后意义

张凤春^1,2, 江莺³, 刘照南⁴, 闫宁宁^1,2, 崔洪全¹, 徐迎春⁴

1.上海交通大学医学院附属苏州九龙医院肿瘤科(苏州 215021);
2.上海交通大学医学院附属瑞金医院肿瘤科;
3.上海嘉定区中心医院肿瘤科;
4.上海交通大学医学院附属仁济医院肿瘤科

收稿日期:2018-04-20 出版日期:2019-02-28 发布日期:2019-02-13
通讯作者: 江莺,E-mail:13795454055@139.com
作者简介:张凤春,男,(1957-),博士,主任医师,从事胃癌相关的研究。
基金资助:
国家自然科学基金(编号:81301858);苏州市科技计划项目(编号:SYS201404;SYS201508)

Prognostic significance of neutrophil/lymphocyte ratio and platelet/lymphocyte ratio in systemic inflammation-related indicators in gastric cancer patients after radical resection

ZHANG Fengchun^1,2, JIANG Ying³, LIU Zhaonan⁴, YAN Ningning^1,2, CUI Hongquan¹, XU Yingchun⁴

1.Department of Oncology,Suzhou Kowloon Hospital,Shanghai Jiaotong University School of Medicine,Suzhou 215021,China;
2.Department of Oncology,Shanghai Ruijin Hospital,Shanghai Jiaotong University School of Medicine;
3.Department of Oncology,Center Hospital of Jiading District;
4.Department of Oncology,Renji Hospital,Shanghai Jiaotong University School of Medicine

Received:2018-04-20 Online:2019-02-28 Published:2019-02-13

摘要/Abstract

摘要： 目的比较胃癌患者术前不同系统性炎症性评分指标:中性粒细胞/淋巴细胞比值(Neutrophil lymphocyte ratio,NLR)、血小板/淋巴细胞比值(Platelet lymphocyte ratio,PLR)的短期及长期预后意义。方法回顾性分析2009年1月—2009年12月上海仁济医院行根治性手术治疗的240例胃癌患者的临床资料,比较NLR、PLR和格拉斯哥预后评分(Glasgow prognostic score,GPS)与临床病理特征和围手术期并发症的关系,生存分析采用Kaplan-Meier方法、Log-rank法检验差异显著性,多因素分析采用Cox回归风险模型进行。结果高NLR和高PLR组患者年龄大、GPS高、肿瘤浸润深度深、淋巴结转移多、TNM分期晚(P＜0.05)。高NLR组切缘阳性比例高(P＜0.05)。高NLR和高PLR组患者术中需要输血比例明显高于低NLR和低PLR组(P＜0.05),高NLR组具有更多的术后并发症(P＜0.05)。单因素分析显示,年龄、GPS、肿瘤部位、肿瘤浸润深度、淋巴结转移状态、TNM分期、脉管癌栓、神经浸润、NLR和PLR均与胃癌患者术后生存期相关(P＜0.05);高NLR组和高PLR组的总生存期(Overall survival,OS)低于低NLR和低PLR组(P=0.018和P＜0.001);COX多因素分析显示,GPS和淋巴结转移状态是影响OS的独立预后因素(P＜0.001和P=0.002)。结论术前系统性炎症性评分指标NLR、PLR是影响胃癌围手术期临床转归的预后因素,建议可与临床常规应用的其他预后指标联合用于胃癌根治术后患者的预后评估。

关键词: 胃癌, 中性粒细胞/淋巴细胞比值, 血小板/淋巴细胞比值, 预后

Abstract: Objective The aim of this study was to compare the short-term and long-term prognostic significance of different systemic inflammatory scores in patients with gastric cancer:neutrophil lymphocyte ratio(NLR)and platelet lymphocyte ratio(PLR).Methods The clinical data of 240 patients with gastric cancer who underwent radical surgery were retrospectively analyzed.The relationship between NLR,PLR,glasgow prognostic score(GPS)and clinicopathological characteristics and perioperative complications were compared.Survival analysis was performed using Kaplan-Meier survival analysis.The Log-rank methods were used to test the difference significance,and the multivariate analysis was performed using the Cox regression risk model.Results Patients in the high NLR and PLR groups were older,had a high GPS,deep tumor infiltration,more lymph node metastasis,and a late TNM stage(P＜0.05).The rate of positive margin in the high NLR group was higher(P＜0.05).Patients in the high NLR and PLR groups required significantly higher transfusion rates than those in the low NLR and PLR groups(P＜0.05),and the high NLR group had more postoperative complications(P＜0.05).Univariate analysis showed that age,GPS,tumor location,tumor infiltration depth,lymph node metastasis status,TNM stage,vascular tumor thrombus,nerve infiltration,NLR and PLR were associated with postoperative survival of gastric cancer patients(P＜0.05).The overall survival(OS)in high NLR and high PLR groups was lower than that of low NLR and low PLR groups(P=0.018 and P＜0.001).Cox regression analysis showed GPS and lymph node metastasis were independent prognostic factors of OS(P＜0.001 and P=0.002).Conclusion Preoperative systemic inflammatory scores NLR and PLR are prognostic factors affecting the preoperative clinical outcomes of gastric cancer.It is recommended to be used in combination with other prognostic indicators for routine use in the prognosis of patients undergoing radical gastrectomy.

Key words: Gastric cancer, Nutrophil lymphocyte ratio, Patelet lymphocyte ratio, Prognosis

中图分类号:

735.2

张凤春, 江莺, 刘照南, 闫宁宁, 崔洪全, 徐迎春. 系统性炎症相关指标中性粒细胞/淋巴细胞比值及血小板/淋巴细胞比值在根治性切除术后的胃癌患者的预后意义[J]. 实用肿瘤学杂志, 2019, 33(1): 34-39.

ZHANG Fengchun, JIANG Ying, LIU Zhaonan, YAN Ningning, CUI Hongquan, XU Yingchun. Prognostic significance of neutrophil/lymphocyte ratio and platelet/lymphocyte ratio in systemic inflammation-related indicators in gastric cancer patients after radical resection[J]. PRACTICAL ONCOLOGY JOURNAL, 2019, 33(1): 34-39.

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系统性炎症相关指标中性粒细胞/淋巴细胞比值及血小板/淋巴细胞比值在根治性切除术后的胃癌患者的预后意义

Prognostic significance of neutrophil/lymphocyte ratio and platelet/lymphocyte ratio in systemic inflammation-related indicators in gastric cancer patients after radical resection

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