Correlation between preoperative NLR, PLR, and RDW and clinical pathological parameters in gastric cancer patients
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摘要:
目的 研究外周血中性粒细胞与淋巴细胞比值（neutrophil-to-lymphocyte ratio，NLR）、血小板与淋巴细胞比值（platelet-tolymphocyte ratio，PLR）、红细胞分布宽度（red blood cell distribution width，RDW）与胃癌患者术后临床病理参数之间的关系。 方法 回顾性分析福建省肿瘤医院2012年2月至2014年12月初诊入院手术的434例胃癌患者术前全血细胞计数及术后病理资料，同时选取年龄及性别匹配的342例慢性萎缩性胃炎患者及309例健康对照者进行对比分析。 结果 胃癌组NLR、PLR和RDW的中位数值显著高于胃炎及正常对照组（P < 0.000 1）。Kruskal-Wallis相关分析显示患者NLR、PLR及RDW值随着病理分期的进展逐步升高（NLR、PLR：P < 0.000 1；RDW：P < 0.05），但与肿瘤分化程度和肿瘤生长部位无显著相关。多因素回归分析结果表明NLR和PLR是肿瘤病理分期和T分期的独立相关因素（P < 0.000 1）。ROC曲线分析结果显示NLR和PLR对术前预判胃癌T分期有一定诊断疗效。 结论 胃癌患者术前NLR及PLR值与胃癌TNM分期密切相关，可作为术前分期预判的非特异性标志物。 -
关键词:
- 胃癌 /
- TNM分期 /
- 中性粒细胞与淋巴细胞比值 /
- 血小板与淋巴细胞比值 /
- 红细胞分布宽度
Abstract:Objective To assess the association between preoperative neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and red cell distribution width (RDW) and the tumor pathological features in gastric cancer (GC) patients. Methods We reviewed the records of 434 patients from 2012 to 2014 in Fujian Cancer Hospital. All patients were admitted to the hospital for the first time, and no patients received any cancer-specific pretreatment. For comparison, 309 age-and gender-matched healthy individuals who underwent annual physical examination at the hospital and 342 patients with chronic atrophic gastritis were enrolled. Results GC patients had higher NLR, PLR, and RDW than the controls (P < 0.000 1). Elevated NLR, PLR, and RDW were associated with the development of tumor stages as indicated by the Kruskal-Wallis analysis. However, no similar association was observed between the tumor differentiation grade and location and those three markers. Multivariate regression analysis further revealed that both NLR and PLR were independent predicting factors for either the tumor TNM or T stage (P < 0.000 1). ROC curve analysis showed that NLR and PLR had a certain diagnostic effect on the preoperative T staging of GC. Conclusion The preoperative NLR and PLR levels are closely correlated with the tumor TNM stages in GC patients. Both these parameters have potential values as markers to assist either in early diagnosis or preoperative tumor stage evaluation in GC. -
图 1 胃癌患者不同部位和不同分化程度的NLR、PLR、RDW值比较
Figure 1. Comparative distribution of NLR, PLR, and RDW in GC patients with varying tumor locations and differentiation degrees
表 1 胃癌组、胃炎组及正常对照组的基本信息
Table 1. Demographic information of GC patients, gastritis patients, and controls
表 2 胃癌、胃炎及正常对照组之间数据的两两比较
Table 2. Multiple comparisons of GC patients, gastritis patients, and controls
表 3 胃癌患者不同病理分期与各实验室检测指标的关系
Table 3. Association between laboratory data and tumor stages in GC patients
表 4 不同TNM分期与炎性指标NLR、PLR、RDW的关系
Table 4. Association between NLR, PLR, and RDW and the TNM stages in GC patients
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[1] Sarraf KM, Belcher E, Raevsky E, el al. Neutrophil/lymphocyte ratio and its association with survival after complete resection in nonsmall cell lung cancer[J]. J Thoac Cardiovas Surg, 2009, 137(2):425-428. doi: 10.1016/j.jtcvs.2008.05.046 [2] Li MX, Liu XM, Zhang XF, et al. Prognostic role of neutrophil-to-lymphocyte ratio in colorectal cancer:a systematic review and metaanalysis[J]. Int J Cancer, 2014, 134(10):2403-2413. doi: 10.1002/ijc.v134.10 [3] Pichler M, Hutterer GC, Stoeckigt C, et al. Validation of the pretreatment neutrophil-lymphocyte ratio as a prognostic factor in a large European cohort of renal cell carcinoma patients[J]. Br J Cancer, 2013, 108(4):901-907. doi: 10.1038/bjc.2013.28 [4] Deng QW, He BS, Liu X, et al. Prognostic value of pre-operative inflammatory response biomarkers in gastric cancer patients and the construction of a predictive model[J]. J Transl Med, 2015, 13:66. doi: 10.1186/s12967-015-0409-0 [5] Gunduz S, Mutlu H, Tural D, et al. Platelet to lymphocyte ratio as a new prognostic for patients with metastatic renal cell cancer[J]. Asia Pac J Clin Oncol, 2015, 11(4):288-292. doi: 10.1111/ajco.2015.11.issue-4 [6] Koma Y, Onishi A, Matsuoka H, et al. Increased red blood cell distribution width associates with cancer stage and prognosis in patients with lung cancer[J]. PLoS One, 2013, 8(11):e80240. doi: 10.1371/journal.pone.0080240 [7] Wang FM, Xu GJ, Zhang Y, et al. Red cell distribution width is associated with presence, stage, and grade in patients with renal cell carcinoma[J]. Dis Markers, 2014, 2014:860419. https://www.researchgate.net/profile/Gongjun_Xu/publication/270827537_Red_Cell_Distribution_Width_Is_Associated_with_Presence_Stage_and_Grade_in_Patients_with_Renal_Cell_Carcinoma/links/55b135bd08aec0e5f4310f0d.pdf?inViewer=0&pdfJsDownload=0&origin=publication_detail [8] Ay S, Eryilmaz MA, Aksoy N, et al. Is early detection of colon cancer possible with red blood cell distribution width[J]? Asian Pac J Cancer Prev, 2015, 16(2):753-756. doi: 10.7314/APJCP.2015.16.2.753 [9] Dutta S, Crumley AB, Fullarton GM, et al. Comparison of the prognostic value of tumour and patient related factors in patients undergoing potentially curative resection of gastric cancer[J]. Am J Surg, 2012, 204(3):294-299. doi: 10.1016/j.amjsurg.2011.10.015 [10] Lee S, Oh SY, Kim SH, et al. Prognostic significance of neutrophil lymphocyte ratio and platelet lymphocyte ratio in advanced gastric cancer patients treated with FOLFOX chemotherapy[J]. BMC Cancer, 2013, 13:350. doi: 10.1186/1471-2407-13-350 [11] Coussens LM, Werb Z. Inflammation and cancer[J]. Nature, 2002, 420(6917):860-867. doi: 10.1038/nature01322 [12] Farah R, Khamisy-Farah R. Association of neutrophil to lymphocyte ratio with presence and severity of gastritis due to Helicobacter pylori infection[J]. J Clin Lab Anal, 2014, 28(3):219-223. doi: 10.1002/jcla.21669 [13] Mariani F, Sena P, Roncucci L. Inflammatory pathways in the early steps of colorectal cancer development[J]. World J Gastroenterol, 2014, 20(29):9716-9731. doi: 10.3748/wjg.v20.i29.9716 [14] Jia J, Zheng XW, Chen Y, et al. Stage-dependent changes of preoperative neutrophil to lymphocyte ratio and platelet to lymphocyte ratio in colorectal cancer[J]. Tumor Biol, 2015, 36(12):9319-9325. doi: 10.1007/s13277-015-3667-9 [15] Fridlender ZG, Albelda SM, Granot Z. Promoting metastasis: neutrophils and T cells join forces[J]. Cell Res, 2015, 25(7):765-766. doi: 10.1038/cr.2015.62 [16] Coffelt SB, Kersten K, Doornebal CW, et al. IL-17-producing γδ T cells and neutrophils conspire to promote breast cancer metastasis [J]. Nature, 2015 522(7556):345-348. doi: 10.1038/nature14282 [17] van Rossum AP, Vlasveld LT, Vlasveld IN, et al. Granulocytosis and thrombocytosis in renal cell carcinoma: a pro-inflammatory cytokine response originating in the tumour[J]. Neth J Med, 2009, 67 (5):191-194. https://www.researchgate.net/publication/26651472_Granulocytosis_and_thrombocytosis_in_renal_cell_carcinoma_A_pro-inflammatory_cytokine_response_originating_in_the_tumour [18] Goubran HA, Stakiw J, Radosevic M, et al. Platelet-cancer interactions[J]. Semin Thromb Hemost, 2014, 40(3):296-305. doi: 10.1055/s-00000077 [19] Kaser A, Brandacher G, Steurer W, et al. Interleukin-6 stimulates thrombopoiesis through thrombopoietin: role in inflammatory thrombocytosis[J].Blood, 2001, 98(9):2720-2725. doi: 10.1182/blood.V98.9.2720 [20] Goubran HA, Burnouf T, Radosevic M, et al. The platelet-cancer loop [J]. Eur J Intern Med, 2013, 24(5):393-400. doi: 10.1016/j.ejim.2013.01.017 [21] Salvagno GL, Sanchis-Gomar F, Picanza A, et al. Red blood cell distribution width:A simple parameter with multiple clinical applications [J]. Crit Rev Clin Lab Sci, 2015, 52(2):86-105. doi: 10.3109/10408363.2014.992064 [22] Spell DW, Jones DV Jr, Harper WF, et al. The value of a complete blood count in predicting cancer of the colon[J]. Cancer Detect Prev, 2004, 28(1):37-42. doi: 10.1016/j.cdp.2003.10.002 [23] 蔡军, 尹杰, 宋建宁, 等.胃癌患者外周血中性粒细胞与淋巴细胞比值的临床意义研究[J].临床和实验医学杂志, 2014, 13(12):996-998. http://www.cnki.com.cn/Article/CJFDTOTAL-SYLC201412017.htmCai J, Yin J, Song JN, etal.Study on significance of neutrophil to lymphocyte ratio (NLR) in patients with gastric cancer[J]. Journal of Clinical and Experimental Medicine, 2014, 13(12):996-998. http://www.cnki.com.cn/Article/CJFDTOTAL-SYLC201412017.htm [24] 李书梅, 徐小莉, 梁迪, 等.外周血中性粒细胞与淋巴细胞比值以及血小板与淋巴细胞比值评估胃癌患者预后的价值[J].中华肿瘤杂志, 2014, 36(12):910-915. http://med.wanfangdata.com.cn/Paper/Detail/PeriodicalPaper_zhzl201412007Li SM, Xu XL, Liang D, et al. Prognostic value of blood neutrophil-tolymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) in patients with gastric cancer[J]. Chin J Oncol, 2014, 36(12):910-915. http://med.wanfangdata.com.cn/Paper/Detail/PeriodicalPaper_zhzl201412007 -
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