【摘要】：目的:探討術(shù)前中性粒細(xì)胞與淋巴細(xì)胞比值(Neutrophil-lymphocyte ratio,NLR)在評估胃癌患者預(yù)后的臨床價值和意義,指導(dǎo)胃癌術(shù)后的治療。方法:選取2010年1月至2011年12月就診于福建醫(yī)科大學(xué)附屬第一醫(yī)院經(jīng)病理學(xué)確診為胃癌的94例患者,并且患者的病例資料、隨訪資料完整,作為本文的回顧性研究對象。收集入選患者的臨床病理資料包括年齡、性別、腫瘤浸潤深度、淋巴結(jié)轉(zhuǎn)移數(shù)目、腫瘤TNM分期、腫瘤大小、腫瘤分化程度等;另外選取患者術(shù)前一周內(nèi)的一次血常規(guī),記錄中性粒細(xì)胞與淋巴細(xì)胞的比值,即術(shù)前NLR值。通過構(gòu)建ROC曲線截取NLR=2.24為其最佳臨界值,將患者分為高NLR組和低NLR組。分析患者各臨床病理因素與術(shù)前NLR之間的關(guān)系;單因素分析和COX回歸分析判斷術(shù)前NLR是否為胃癌患者預(yù)后的影響因素及獨立危險因素。結(jié)果:在94例病例中,男性患者69例,占73%,術(shù)前NLR均數(shù)為2.49±1.37;女性患者25例,占27%,術(shù)前NLR均數(shù)為2.49±1.17。年齡≥65歲患者34例,術(shù)前NLR均數(shù)為2.48±1.13;年齡65歲患者60例,術(shù)前NLR均數(shù)為2.50±1.42。腫瘤大小≥4cm的患者53例,腫瘤大小4cm的患者有41例。腫瘤浸潤深度T1+T2和T3+T4的患者分別有26例和68例。淋巴結(jié)轉(zhuǎn)移中:N0+N1和N2+N3的患者分別有49例、45例。TNM中I期+II期和III期患者分別為44例、50例。中-高分化患者28例,術(shù)前NLR均數(shù)為2.61±1.92;低分化患者66例,術(shù)前NLR均數(shù)為2.44±1.00。術(shù)前低NLR組(NLR2.24)和高NLR組(NLR≥2.24)的5年生存率分別為69%和30%。術(shù)前低NLR組(NLR2.24)的患者生存率明顯優(yōu)于高NLR組(NLR≥2.24),即高NLR組患者預(yù)后比低NLR組預(yù)后差,差異具有統(tǒng)計學(xué)意義(P=0.000)。COX回歸分析提示,術(shù)前NLR可成為單獨影響胃癌患者預(yù)后的簡單臨床因素;此外,淋巴結(jié)轉(zhuǎn)移數(shù)目、腫瘤TNM分期、腫瘤大小、腫瘤浸潤深度等可影響胃癌患者預(yù)后。結(jié)論:1.術(shù)前NLR是影響胃癌患者預(yù)后的重要因素,術(shù)前NLR≥2.24的胃癌患者預(yù)后顯著差于NLR2.24的胃癌患者。2.術(shù)前NLR與患者的腫瘤浸潤深度、淋巴結(jié)轉(zhuǎn)移數(shù)目、腫瘤TNM分期顯著相關(guān),與患者年齡、性別、腫瘤大小、腫瘤分化程度無關(guān)。3.由單、多因素分析得出術(shù)前NLR是胃癌患者預(yù)后的獨立危險因素。
[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 鹵1.37 before operation, 25 cases (27.7%) of female patients, the mean of preoperative NLR was 2.49 鹵1.17 (P < 0.05). The mean preoperative NLR was 2.48 鹵1.13 in 34 patients aged 鈮，

本文編號：2279947