术前中性/淋巴细胞比例对胃癌预后的评估价值

目的术前外周血中性/淋巴细胞比例检测对评估胃癌预后价值。方法 213例胃癌患者术前取外周血行血常规检测,按中性/淋巴细胞比例（neutrophil-lymphocyte ratio,NLR）是否大于4分为高NLR组及低NLR组,收集患者术后病理TNM分期情况并随访。以NLR为因变量对胃癌患者临床病理分期进行多因素回归分析,对比两组患者的1、3、5年生存率,分析NLR是否为胃癌患者预后的独立预测指标。结果患者性别、年龄、肿瘤侵润、淋巴结转移、远处转移及血小板计数等因素均与NLR升高有相关关系,差异有统计学意义（P〈0.05）。T≥T3、N≥N1、血小板计数≥350×10~9/L患者中NLR≥4者的比例更高,差异有显著统计学意义（P〈0.01）。年龄≥65岁、血小板计数≥350×10~9/L及淋巴结转移为导致高NLR的独立危险因素（P〈0.05）。低NLR组（NLR〈4）1、3、5年累计生存率为92.6%、84.7%、64.1%,高NLR组（NLR≥4）1、3、5年累计生存率为80.1%、50.8%、44.4%,两组生存率相比,差异有统计学意义（P〈0.05）。结论高NLR值是胃癌患者预后不良的独立危险因素,对评估胃癌患者预后有预测价值。

Preoperative neutrophil-lymphocyte ratio as an independent prognostic factor in patients with gastric cancer,

Objective To evaluate the clinicopathological significance of the preoperative neutrophil -lymphocyte ratio(NLR),and the postoperative outcomes of gastric cancer cases in relation to the NLR as a independent prognostic predict marker.Methods A total of 213 patients with gastric cancer underwent radical gastrectomy(subtotal or total) were included.NLR<4 and NLR≥4 were classified as low and high NLR group,respectively.The prognostic significance in relation to the NLR together with various clinicopathological factors was evaluated by multivariate analysis.Results The 1,3, 5-year survival of patients with a high NLR was significantly worse than that with a low NLR(80.1%, 50.8%,44.4%vs.92.6%,84.7%,64.1%,P<0.05).Multivariate analysis of clinicopathological factors affecting NLR revealed that age≥65 years,depth of tumor,positive lymph nodes and high platelet count were significant risk factors for increased NLR.Conclusion A high preoperative NLR may be a convenient biomarker to identify patients with a poor prognostic outcome after gastrectomy for gastric cancer.