中性粒细胞／淋巴细胞比值在胃癌预后评估中的应用

目的探讨中性粒细胞／淋巴细胞比值（NLR）是否可以作为胃癌患者的预后指标。方法回顾性分析1994—2006年间中山大学附属第一医院胃肠外科收治的经手术治疗的775例胃癌患者的临床资料,根据患者术前外周静脉血NLR大小分为低NLR组（NLR小于或等于3．79,652例）和高NLR组（NLR大于3．79,123例）,比较两组患者的5年生存率：并进一步按TNM分期和手术方式进行分层分析。结果低NLR组和高NLR组胃癌患者5年生存率分别为44．0％和12．2％（P〈0．01）。TNMⅠ、Ⅱ、ⅢA、ⅢB及Ⅳ期病例中,低NLR组和高NLR组的5年生存率分别为97．8％和33．3％、55．4％和32．0％、30．2％和11．1％、15．5％和8．3％、10．7％和2．1％．差异均有统计学意义（均P〈0．01）。行D1、D2、D3、D4根治性手术及姑息性手术病例中,低NLR组和高NLR组的5年生存率分别为93．3％和33．3％、51．3％和20．4％、42．4％和10．5％、14.3％和2．0％、8．3％和2．2％。差异均有统计学意义（均P〈0．01）。结论NLR可以作为胃癌患者的预后因素,术前NLR大于3．79提示胃癌患者预后不良。

Neutrophil-lymphocyte ratio as a prognostic factor in gastric cancer

Objective To explore whether neutrophil-lymphocyte ratio (NLR) is an effective prognostic marker in gastric cancer.Methods Clinical data of 775 patients with gastric cancer in the First Affiliated Hospital of Sun Yat-sen University from 1994 to 2006 were analyzed retrospectively.According to preoperative NLR,the patients were divided into the low NLR group(NLR≤3.79,n=652)and the high NLR group (NLR＞3.79,n=123).The 5-year survival rates of two groups of different TNM stage,different surgical intervention were separately analyzed.Results The 5-year survival rates in the low NLR group and high NLR group were 44.0％ and 12.2％ respectively (P＜0.01).In different TNM stages: stage Ⅰ (97.8％ vs 33.3％),stage Ⅱ (55.4％ vs 32.0％),stage ⅢA(30.2％ vs 11.1％),stage Ⅲ B (15.5％ vs 8.3％),stage Ⅳ (10.7％ vs 2.1％),and in different surgical intervention: D1 curative gastrectomy (93.3％ 33.3％),D2 group (51.3％ vs 20.4％),D3 group (42.4％ vs 10.5％),D4 group (14.3％ vs 2.0％),and in palliative operation group(8.3％ vs 2.2％).There were significant differences of 5-year survival rate in TNM staging and surgical procedures between the high and low NLR groups (all P＜0.05).Conclusion Preoperative NLR may be a prognostic marker in patients with gastric cancer.