血清胆碱酯酶水平和中性粒细胞/淋巴细胞比值与接受一线化疗晚期胃癌患者预后的相关性分析

目的探讨治疗前血清胆碱酯酶(CHE)和中性粒细胞/淋巴细胞比值(NLR)与接受一线化疗晚期胃癌患者预后的相关性,建立晚期胃癌患者的预后列线图预测模型并进行验证。方法对2010年1月至2018年10月在徐州医科大学附属淮安医院诊断为晚期胃癌且接受一线化疗的97列患者进行回顾性分析。利用X-tile程序计算CHE、NLR的最佳截断值,并检测两者之间的相关性。采用多因素Cox风险比例回归模型筛选晚期胃癌独立预后因素,通过R软件绘制列线图并进行内部验证。结果 CHE最佳截断值为3167 U/L,NLR最佳截断值为3.5。CHE与NLR呈负相关(r=-0.299,P=0.003)。结果显示,CHE仅与糖类抗原125(CA125)有关(P=0.029);NLR与年龄、ECOG评分、CA125有关(P<0.05)。多因素Cox回归分析结果显示,CHE、NLR、ECOG评分、CA125是影响晚期胃癌预后的独立因素。构建的列线图具有较好的区分度和校准度,包含CHE列线图预测模型的一致性指数(C-index)为0.685,0.5、1、3、5年生存率的受试者工作特征曲线(ROC)曲线下面积分别为0.8...

Correlation between serum cholinesterase and neutrophil-to-lymphocyte and prognosis of advanced gastric cancer treated with first-line therapy

Objective To investigate the correlation between serum cholinesterase(CHE)and neutrophil/lymphocyte ratio(NLR)before treatment and the prognosis of patients with advanced gastric cancer receiving first-line chemotherapy,and to establish a prognostic nomogram prediction model and validate its accuracy.Methods We retrospectively enrolled 97 patients who were pathologically diagnosed with advanced gastric cancer and treated with first-line chemotherapy at the Affiliated Huai'an Hospital of Xuzhou Medical University from January 2010 to October 2018 into this study.The optimal cutoff values of CHE and NLR were calculated by X-tile program.Spearman correlation analysis was applied to analyze the correlation between CHE and NLR.Multivariate Cox risk proportional regression model was used to explore the predictors significantly associated with the overall survival(OS),and R software was used to draw the nomogram,which was verified internally.Results X-tile plots identified 3167 U/L and 3.5 as cutoff values for CHE and NLR,respectively.CHE was negatively associated with NLR(r=-0.299,P=0.003).The results showed that CHE was only related to carbohydrate antigen 125(CA125)(P=0.029),and NLR was related to age,ECOG scores and CA125(P<0.05).Multivariate Cox regression analysis showed that CHE,NLR,ECOG scores and CA125 were independent predictors of OS in patients with advanced gastric cancer.This model had good discrimination and calibration,the C-index of the nomogram in this study was 0.685,and the areas under the ROC curve of 0.5,1,3 and 5-year survival rates were 0.857,0.764,0.751 and 0.711 respectively.The nomogram containing CHE was more powerful than the nomogram without CHE in predicting the OS of advanced gastric cancer patients.Conclusion CHE can be used to predict the prognosis of patients with advanced gastric cancer.The nomogram including CHE has a good coincidence,predicting the prognosis of advanced gastric cancer accurately.