李石, 周杰, 赵平, 贺巧, 罗怀超. cN0期胃癌患者术前中性粒细胞淋巴细胞比 血小板淋巴细胞比和C反应蛋白白蛋白比与术后淋巴结转移的关系[J]. 中国肿瘤临床, 2021, 48(5): 230-234. DOI: 10.3969/j.issn.1000-8179.2021.05.198
引用本文: 李石, 周杰, 赵平, 贺巧, 罗怀超. cN0期胃癌患者术前中性粒细胞淋巴细胞比 血小板淋巴细胞比和C反应蛋白白蛋白比与术后淋巴结转移的关系[J]. 中国肿瘤临床, 2021, 48(5): 230-234. DOI: 10.3969/j.issn.1000-8179.2021.05.198
shu
Shi Li, Jie Zhou, Ping Zhao, Qiao He, Huaichao Luo. Relations of NLR, PLR and CAR to postoperative lymph node metastasis in patients with cN0 gastric cancer[J]. CHINESE JOURNAL OF CLINICAL ONCOLOGY, 2021, 48(5): 230-234. DOI: 10.3969/j.issn.1000-8179.2021.05.198
Citation: Shi Li, Jie Zhou, Ping Zhao, Qiao He, Huaichao Luo. Relations of NLR, PLR and CAR to postoperative lymph node metastasis in patients with cN0 gastric cancer[J]. CHINESE JOURNAL OF CLINICAL ONCOLOGY, 2021, 48(5): 230-234. DOI: 10.3969/j.issn.1000-8179.2021.05.198
shu

cN0期胃癌患者术前中性粒细胞淋巴细胞比 血小板淋巴细胞比和C反应蛋白白蛋白比与术后淋巴结转移的关系

Relations of NLR, PLR and CAR to postoperative lymph node metastasis in patients with cN0 gastric cancer

    摘要
  • 摘要:
      目的  探讨cN0期（术前影像学诊断）胃癌患者术前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-to-lymphocyte ratio，PLR）和C反应蛋白（C-reactive protein，CRP）与白蛋白比值（C-reac?tive protein-to-albumin ratio，CAR）等系统性炎症反应指标与患者术后淋巴结转移的关系，并建立指数预测模型。
      方法  回顾性分析四川省肿瘤医院2019年1月至12月行根治性手术切除的cN0期胃癌患者206例，按照术后病理诊断分为淋巴结转移组（grouppN+）和无淋巴结转移组（group pN0），同时选取200例同期健康体检者作为健康对照组，比较炎症反应指标之间的差异，以及NLR、PLR、CAR与淋巴结转移数、转移率、淋巴结状态等之间的关系，利用多因素Logistic回归模型筛选cN0期胃癌患者淋巴结转移的独立危险因素。
      结果  pN+组胃癌患者术前白细胞计数、中性粒细胞计数、CRP、PLR、NLR、CAR、癌胚抗原（carcinoembryonicantigen，CEA）明显高于pN0组患者，差异均具有统计学意义（均P< 0.05），而pN0组与健康对照组之间差异均无统计学意义（均P>0.05）；而淋巴细胞计数、血小板计数和白蛋白水平的组间差异无统计意义（均P> 0.05）。术前高NLR组、高PLR组和高CAR组患者的淋巴结分期构成及淋巴结转移数量分别低于术前低NLR组、低PLR组和低CAR组，差异具有统计学意义（均P< 0.05）。单因素及多因素Logistic回归分析显示，肿瘤大小、浸润深度、NLR和CAR是术前诊断为cN0期胃癌患者术后淋巴结转移的独立危险因素，OR值分别为1.358、8.174、3.049和2.254。术前诊断cN0期胃癌患者淋巴结转移的指数预测模型表达式为h（t）=h0exp（1.358X1+8.174X2+3.049X3+2.254X4）。
      结论  术前高PLR、NLR和CAR水平与患者淋巴结分期及淋巴结转移数量密切相关，术前高NLR和CAR水平是cN0期胃癌患者淋巴结转移的独立影响因素。

     

    Abstract:
      Objective  To investigate the relation between inflammatory response indicators, such as the neutrophil-to-lymphocyte ratio (NLR), the platelet-to-lymphocyte ratio (PLR) and C-reactive protein-to-albumin ratio (CAR), and lymph node metastasis in patients with cN0 gastric cancer, and establish a prediction model.
      Methods  206 patients with cN0 gastric cancer (imaging-confirmed) who underwent radical resection in Sichuan Cancer Hospital from January 2019 to December 2019 were retrospectively analyzed, and they were further assigned to the lymph node metastasis group (the pN+group) and the non-lymph node metastasis group (the pN0 group) according to postoperative pathological diagnosis.200 healthy individuals who underwent annual physical examination at the same hospital were enrolled as the control group.Differences in inflammatory response indicators among the three groups were compared.We then assessed the relations of NLR, PLR and CAR to the number of metastatic lymph nodes, ratio of metastasis and lymph node stage, respectively.Independent risk factors for lymph node metastasis in patients with cN0 gastric cancer were screened using both univariate and multivariate Logistic regression models, and a predictive model was constructed correspondingly.
      Results  Leukocyte count, neutrophil count, C-reactive protein (CRP) level, PLR, NLR, CAR and carcinoembryonic antigen level in the pN+group were significantly higher than those in the pN0 group(all P< 0.05);and there were no statistically significant differences in the above parameters between the pN0 group and the control group (all P>0.05).Differences in lymphocyte count, platelet count and albumin level were not statistically significant among the three groups (all P>0.05).Both the number of metastatic lymph nodes and the stage of lymph nodes in patients with high NLR, PLR and CAR were significantly higher than those in patients with low NLR, PLR and CAR, respectively (all P< 0.05).Univariate and multivariate Logistic regression analyses showed that tumor size (OR=1.358), depth of invasion (OR=8.174), NLR (OR=3.049) and CAR (OR=2.254) were independent risk factors for lymph node metastasis in patients with cN0 gastric cancer.The prediction model for lymph node metastasis in patients with cN0 gastric cancer was established based on the following formula: h(t)=h0exp (1.358X1+8.174X2+3.049X3+2.254X4).
      Conclusions  High PLR, NLR and CAR before operation are closely related to lymph node stage and the number of metastatic lymph nodes.High NLR and CAR before operation are independent factors for lymph node metastasis in patients with cN0 gastric cancer.

     

    • HTML全文
    • 参考文献(20)
    • 相关文章
    • 施引文献
  • 资源附件(0)

/

返回文章
返回