胃癌患者术前中性粒细胞/ 淋巴细胞比值 与临床病理特征的关系

The relationship between preoperative neutrophil lymphocyte ratio and clinicopathological features in patients with gastric cancer

摘要:

目的 探讨胃癌患者术前中性粒细胞/ 淋巴细胞比值（NLR）分布与临床病理特征等相关因素 的关系。方法 选取2016 年8 月—2017 年12 月在安徽医科大学第一附属医院行胃癌根治术患者706 例。根 据NLR 值将患者分为高NLR 组和低NLR 组。收集患者入院第1 次血常规检验结果，包括中性粒细胞计数、 淋巴细胞计数。记录患者性别、年龄、体重指数（BMI）、肿瘤浸润深度、淋巴结转移程度分期、远处转移、 临床病理分期、组织分化类型、组织分化程度、肿瘤位置、检出淋巴结个数、转移淋巴结个数、肿瘤最大径 及CEA 等相关数据。采用单因素或多因素分析胃癌患者NLR 分布的影响因素。结果 男女性NLR 分布比较， 差异无统计学意义（P >0.05）。23 ～ 44 岁、45 ～ 59 岁、60 ～ 85 岁患者NLR 分布比较，差异无统计学意义 （P >0.05）。两组BMI、浸润深度、淋巴结转移程度分期、临床病理分期及肿瘤最大径比较，差异有统计学意 义（P <0.05）。多因素Logistic 回归分析结果显示，肿瘤最大径是NLR 的独立影响因素[Ol ^ R=1.790，95% CI （1.094，2.928）]，高NLR 组的患病风险是低NLR 组的1.790 倍（95% CI ：1.094，2.928）。结论 术前NLR 对肿瘤浸润深度及淋巴结转移分期有提示作用，NLR 同时受BMI 的影响，肿瘤最大径可作为影响NLR 的独 立影响因素。

Abstract:

Objective To explore the relationship between neutrophil lymphocyte ratio (NLR) and clinicopathological features in patients with gastric cancer. Methods A total of 706 patients with gastric cancer who underwent radical gastrectomy were selected from the First Affiliated Hospital of Anhui Medical University from August 2016 to December 2017. Patients were divided into high NLR group and low NLR group according to NLR value. The results of the first blood routine test were collected, including neutrophil count and lymphocyte count. The patient’s sex, age, BMI, T stage (invasion depth), N stage, M stage, pTNM, tissue differential type, tissue differential degree, tumor location, number of detected lymph nodes, number of metastatic lymph nodes, maximum diameter of tumor and carcinoembryonic antigen (CEA) were recorded. Univariate analysis and multivariate analysis were used to analyze the influencing factors of NLR distribution in gastric cancer patients. Results The difference was not statistically significant in sex, age, tissue differential type, tissue differential degree, M-stage, tumor location and CEA compared with NLR (P > 0.05). BMI, T stage, N stage, pTNM and maximum diameter of tumor were significantly different from NLR (P < 0.05). Multivariate logistic regression analysis showed that the maximum diameter of tumor was an independent risk factor affecting NLR (P = 0.020) and the risk of NLR in high NLR group was 1.790 times higher than that in low NLR group (95% CI: 1.094, 2.928). Conclusions Preoperative NLR has a suggestive effect on the depth of tumor invasion and lymph node involvement. It is also affected by BMI. The maximum diameter of tumor can be used as an independent risk of affecting NLR in the multivariate analysis.