CAJ | 학술논문

目的探讨外周血中性粒细胞与淋巴细胞比值(NLR)以及血小板与淋巴细胞比值(PLR)与胃癌患者预后的关系.方法收集591例有明确病理诊断的胃癌患者的临床病理及随访资料,利用Kaplan-Meier法计算生存率,Log rank检验比较不同组间的差异.采用Cox回归分析对可能影响患者预后的因素进行分析.结果获得随访538例,随访率为91.0％.538例患者中,353例死于胃癌,185例生存.538例胃癌患者的1、3、5年生存率分别为69.9％、47.0％和37.5％,其中低NLR组患者的1、3、5年生存率分别为76.1％、50.1％和42.7％;高NLR组患者的1、3、5年生存率分别为53.1％、38.6％和23.4％,差异有统计学意义(P＜0.05).单因素分析显示,胃癌患者的预后与患者的年龄、病理类型、TNM分期、是否手术、NLR和PLR水平有关(均P＜0.05).多因素分析显示,TNM分期、是否手术、NLR水平和年龄为影响胃癌患者预后的独立因素(均P＜0.05).根据发病部位进行分层分析的结果显示,TNM分期、是否手术和NLR水平为影响贲门癌患者预后的独立因素(均P ＜0.05).年龄、TNM分期和是否手术为影响远端胃癌患者预后的独立因素(均P＜0.05).结论 NLR可能是影响胃癌患者预后的独立因素.
목적 탐토외주혈중성립세포여림파세포비치(NLR)이급혈소판여림파세포비치(PLR)여위암환자예후적관계.방법 수집591례유명학병리진단적위암환자적림상병리급수방자료,이용Kaplan-Meier법계산생존솔,Log rank검험비교불동조간적차이.채용Cox회귀분석대가능영향환자예후적인소진행분석.결과 획득수방538례,수방솔위91.0％.538례환자중,353례사우위암,185례생존.538례위암환자적1、3、5년생존솔분별위69.9％、47.0％화37.5％,기중저NLR조환자적1、3、5년생존솔분별위76.1％、50.1％화42.7％;고NLR조환자적1、3、5년생존솔분별위53.1％、38.6％화23.4％,차이유통계학의의(P＜0.05).단인소분석현시,위암환자적예후여환자적년령、병리류형、TNM분기、시부수술、NLR화PLR수평유관(균P＜0.05).다인소분석현시,TNM분기、시부수술、NLR수평화년령위영향위암환자예후적독립인소(균P＜0.05).근거발병부위진행분층분석적결과현시,TNM분기、시부수술화NLR수평위영향분문암환자예후적독립인소(균P ＜0.05).년령、TNM분기화시부수술위영향원단위암환자예후적독립인소(균P＜0.05).결론 NLR가능시영향위암환자예후적독립인소.
Objective To explore the prognostic value of neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) in patients with gastric cancer.Methods 591 cases of gastric cancer pathologically diagnosed at the Fourth Hospital of Hebei Medical University in 2006 were included in this study.The clinical information including age and gender,cancer,treatment,and the first blood test information at admission were collected from the medical record room and analyzed.The patients were followed up to March 15,2012.The survival was calculated by Kaplan-Meier analysis.The differences between groups were compared using Log-rank test.Cox regression was used to analyzc the factors which may affect the survival of the patients.Software SPSS 13.0 was used for statistical analysis.Results In 2006,a total of 591 patients were enrolled in this study in accordance with the inclusion criteria.By the end of the study,538 cases were followed up.The follow-up rate was 91.0％.Among them 353 cases died of gastric cancer,185 patients are still alive.In the whole group of 538 cases,the 1-,3-,and 5-year survival rate was 69.9％,47.0％,and 37.5％,respectively.In the low NLR group,the 1-,3-,and 5-year survival rate was 76.1％,50.1％,and 42.7％,respectively,while those of the high NLR group was 53.1％,38.6％,and 23.4％,respectively,showing a significant difference between the two groups (P ＜ 0.05).Univariate analysis showed that the survival rate was significantly correlated with age,pathological type,TNM stage,operation,NLR and PLR (P ＜ 0.05 for all).Multivariate analysis showed that TNM stage,operation,NLR and age of patients were independent risk factors for the prognosis of gastric cancer (P ＜ 0.05 for all).According to the sub-site stratified analysis,TNM stage,operation and NLR were independent risk factors for gastric cardia adenocarcinoma (P ＜ 0.05 for all),and age,TNM stage,operation for distal gastric cancer (P ＜ 0.05 for all).PLR was not an independent prognostic factor of survival in patients with gastric cancer.Conclusion NLR may be an independent prognostic factor of gastric cancer.