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目的:探讨胃癌患者术前中性粒细胞与淋巴细胞比(NLR)与临床病理特征及预后的关系。方法:回顾性分析2010年1月—2011年1月安徽医科大学第一附属医院收治的269例胃癌患者的临床病理及随访资料。根据受试者工作特征曲线,确定NLR的截断值为2.4(敏感性:53.3%,特异性:71.4%),将患者分为低NLR组(NLR<2.4,153例)和高NLR组(NLR≥2.4,116例),比较两组患者临床病理特征及生存率的差异,并分析胃癌患者的预后因素。结果:比较结果显示,两组年龄、性别、淋巴结转移无明显差异(均P>0.05),但高NLR组较低NLR组肿瘤直径大、肿瘤浸润深度深、TNM分期高(均P<0.05);全组患者5年总生存率为44.3%,生存分析显示,高NLR组患者总生存率明显低于低NLR组(χ~2=17.511,P<0.01);单因素分析结果表明,术前NLR、肿瘤大小、肿瘤浸润深度和TNM分期与胃癌患者总生存率有关(均P<0.05),多因素分析显示,NLR和肿瘤大小为影响胃癌患者预后的独立因素(均P<0.05)。结论:术前NLR是影响胃癌患者预后的独立预测因素,高术前NLR值提示胃癌患者有较差的临床病理情况及生存预后。
Objective: To investigate the relationship between preoperative neutrophil and lymphocyte ratio (NLR) and clinicopathological features and prognosis in patients with gastric cancer. Methods: The clinical pathology and follow-up data of 269 gastric cancer patients admitted to the First Affiliated Hospital of Anhui Medical University from January 2010 to January 2011 were retrospectively analyzed. Based on the receiver operating characteristic curve, the cut-off value of NLR was determined to be 2.4 (sensitivity: 53.3%, specificity: 71.4%) and patients were divided into low NLR group (NLR <2.4153) and NLR ≥2.4, 116 cases). The clinicopathological features and survival rates were compared between the two groups. Prognostic factors of gastric cancer were analyzed. Results: The results showed that there was no significant difference between the two groups in age, gender and lymph node metastasis (all P> 0.05). However, in the NLR group with lower NLR, the diameter of the tumor was larger, the depth of tumor infiltration was deeper and the TNM stage was higher (all P <0.05) . The overall 5-year overall survival rate was 44.3%. Survival analysis showed that the overall survival rate in patients with high NLR was significantly lower than that in patients with low NLR (χ ~ 2 = 17.511, P <0.01). The results of univariate analysis showed that preoperative NLR, tumor size, tumor invasion depth and TNM stage were related to the overall survival rate of patients with gastric cancer (all P <0.05). Multivariate analysis showed that NLR and tumor size were independent factors influencing the prognosis of patients with gastric cancer (all P <0.05). Conclusion: Preoperative NLR is an independent predictor of prognosis in patients with gastric cancer. The high preoperative NLR value suggests that patients with gastric cancer have poorer clinical pathology and prognosis.