胃癌患者术前血小板／淋巴细胞比值的预后意义

目的 探讨术前外周血血小板／淋巴细胞比值（PLR）对胃癌患者预后的影响。方法选取2008年9月至2009年12月在本院收治的184例胃癌患者作为研究对象，根据PLR是否＜150，将患者分为低PLR组（＜150）125例和高PLR组（≥150）59例，比较两组的临床病理特征和术后1、2、5年生存率及无病生存率，采用Cox风险回归模型评估影响胃癌患者预后的因素。结果 与低PLR组相比，高PLR组的肿瘤浸润深度深、淋巴结转移数多、TNM分期晚、白蛋白低（P＜0.05）。高PLR组和低PLR组1、2、5年生存率分别为74.6％、54.2％、37.3％ 和89.6％、77.6％、57.6％，两组差异有统计学意义（P=0002）。高PLR组和低PLR组1、2、5年无病生存率分别为52.56％、42.4％、23.7％ 和84.8％、72.0％、49.5％，两组差异有统计学意义（P＜0.001）。单因素分析显示，PLR、肿瘤浸润深度、淋巴结转移、TNM分期、年龄及白蛋白与总生存期（OS）和无病生存期（DFS）有关（P＜0.05）。Cox多因素分析显示，TNM分期是影响OS的独立预后因素（HR=6.344，95％CI：4.125～9.757，P＜0001）；TNM分期、PLR和白蛋白是影响DFS的独立预后因素（HR=4.600，95％CI：3.272～6.468，P＜0.001；HR=1.630，95％CI：1.070～2.483，P=0.023；HR=0.470，95％CI：0.259～0.853，P=0.013）。结论 术前PLR是影响胃癌DFS的独立预后因素，OS的预后意义需进一步研究。

Prognostic significance of reoperative platelet-lymphocyte ratio in patients with gastric cancer

ObjectiveTo explore the prognostic value of preoperative platelet-lymphocyte ratio （PLR）in patients with gastric cancer. Methods In this study， 184 gastric cancer patients from September 2008 to December 2009 in our hospital were selected as research objects. Accoding to whether PLR＜150， patients were divided into low PLR group（＜150） for 125 cases and high PLR group（≥150）for 59 cases. The clinicopathological characteristics， postoperative 1- ， 2- ，5-year survival rates and disease free survival rates of two groups were compared. The prognostic factors were evaluated by Cox multivariate analysis. Results Compared with low PLR group, deeper tumor invasion， more lymph node metastasis，more advanced TNM stage and lower serum albumin level were observed in high PLR group（P＜0.05）. The 1- ， 2- ， 5-year survival rates of high PLR group and low PLR group were 52.56％， 42.4％， 23.7％ and 84.8％， 72.0％， 49.5％，respectively， with statistical differences （P=0.002）. 1- ， 2- ，5- year disease free survival rates of high PLR group and low PLR group were 52.56％、42.4％、23.7％ and 84.8％、72.0％、49.5％， with statistical differences（P＜0.001）. In univariate analysis， PLR， tumor invasion， lymph node metastasis， TNM stage， age and serum albumin were associated with overall survival（OS） and disease free survival（DFS）（P＜0.05）. In Cox multivariate analysis， TNM stage was independent prognostic indicator of OS（HR=6.344，95％CI：4.125-9.757，P＜0.001），and TNM stage， PLR and albumin were independent prognostic indicators of DFS（HR=4. 600，95％CI：3.272-6.468，P＜0001；HR=1.630，95％CI：1.070-2.483，P=0.023；HR=0.470，95％CI：0.259-0.853，P=0.013）. Conclusion PLR is independent prognostic indicator of DFS in patients with gastric cancer. The prognosis implication of PLR for OS remains to be further confirmed.