术前外周血炎性参数与术后淋巴结比率在胃癌化疗患者预后中的作用

任文镇; 王宏浩; 向田; 刘杲

doi:10.3971/j.issn.1000-8578.2023.22.1218

术前外周血炎性参数与术后淋巴结比率在胃癌化疗患者预后中的作用

Role of Preoperative Peripheral Blood Inflammatory Parameters and Postoperative Lymph-node Ratio in Prognosis of Patients with Gastric Cancer Undergoing Chemotherapy

摘要

摘要:
目的分析术前外周血炎性参数与术后淋巴结比率（LNR）在胃癌化疗患者预后中的作用。
方法按外周血中性粒细胞与淋巴细胞比率（NLR）、血小板-淋巴细胞比率（PLR）、全身免疫炎性反应指数（SII）、淋巴细胞-单核细胞比率（LMR）、小野寺预后营养指数（OPNI）、LNR截断值将108例胃癌患者分为高低两组，分析这些炎性参数对胃癌化疗患者总生存期（OS）的预后价值。以独立预后指标绘制列线图预测胃癌患者的存活率。
结果 NLR在胃癌化疗患者的预后评估中有统计学意义（P < 0.001），高PLR组、高SII组、高LNR组、N3分期、TNM（Ⅲ~Ⅳ）分期、神经侵犯、癌胚抗原（CEA）是胃癌预后的独立危险因素（均P < 0.05）。LNR、PLR及SII三者组合（AUC=0.875）在胃癌预后方面的预测效果优于单独或两两联合。
结论 NLR、LNR、PLR及SII升高与患者的生存期显著减少相关；LNR、PLR及SII可作为胃癌化疗患者预后的独立危险因素，三者联合可预测胃癌患者的生存期。

Abstract:
Objective To analyze the role of preoperative peripheral blood inflammatory parameters and postoperative lymph-node ratio (LNR) in the prognosis of gastric cancer patients treated with chemotherapy.
Methods The neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), systemic immune inflammatory response index (SII), lymphocyte-to-monocyte ratio (LMR), Onodera prognostic nutritional index (OPNI), and LNR of 108 patients with gastric cancer were classified into high and low groups to analyze their prognostic value on the overall survival (OS) of gastric cancer patients treated with chemotherapy. The independent prognostic indicators were plotted in columns to predict the survival rate of gastric cancer patients.
Results NLR was statistically significant in the prognostic assessment of gastric cancer patients treated with chemotherapy (P < 0.001). Moreover, the high PLR group, high SII group, high LNR group, N3 stage, TNM (Ⅲ-Ⅳ) stage, nerve invasion, and carcinoembryonic antigen (CEA) were independent risk factors for the prognosis of gastric cancer (all P < 0.05). These findings indicated that in predicting the prognosis of gastric cancer, the combination of LNR, PLR, and SII (AUC=0.875) was better than that of LNR, PLR, and SII alone or in pairwise combination.
Conclusion Elevated NLR, LNR, PLR, and SII are associated with significantly reduced survival of patients. LNR, PLR, and SII could be used as independent risk factors for the prognosis of gastric cancer patients treated with chemotherapy, and their combination can predict the survival of gastric cancer patients.

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