目的: 分析中性粒细胞/淋巴细胞比率(NLR)与进展性胃癌根治术患者术后复发转移的关系。方法: 选取2016年12月至2019年2月收治的在院行进展性胃癌根治术的患者96例作为病例组,另选取同期来院体检的健康志愿者65例作为健康对照组,比较两组NLR水平。随访3年根据末次随访时患者术后有无复发转移分为复发转移组与无复发转移组,比较2组NLR水平及可能影响术后复发转移的相关因素。采用Logistic回归分析法分析进展性胃癌根治术患者术后复发转移的危险因素。绘制受试者工作特征曲线(ROC)分析NLR对进展性胃癌根治术患者术后复发转移的预测价值。结果: 病例组患者NLR水平,与健康对照组比较组间差异有统计学意义(P＜0.05);单因素分析显示两组肿瘤TNM分期、肿瘤分化、浸润深度、术后放化疗、肿瘤直径、NLR均有统计学差异(P＜0.05);多因素分析显示肿瘤TNM分期、浸润深度、肿瘤直径、NLR是进展性胃癌根治术患者术后复发转移的影响因素(P＜0.05);ROC曲线显示,NLR预测进展性胃癌根治术患者术后复发转移的曲线下面积为0.732。结论: 进展性胃癌根治术后患者NLR高表达,NLR可作为影响患者术后复发转移的因素,对其术后复发转移预测具有一定临床价值。
Objective: To analyze the relationship between neutrophil/lymphocyte ratio (NLR) and postoperative recurrence and metastasis in patients with advanced gastric cancer after radical gastrectomy. Methods: A total of 96 patients with advanced gastric cancer who underwent radical gastrectomy in the hospital from December 2016 to February 2019 were selected as the case group, and 65 healthy volunteers who came to the hospital for physical examination during the same period were selected as the healthy control group. The NLR levels of the two groups were compared. After 3 years of follow-up, the patients were divided into recurrence and metastasis group and non-recurrence and metastasis group according to whether there was recurrence and metastasis after operation at the last follow-up. The NLR level and related factors that may affect postoperative recurrence and metastasis were compared between the two groups. Logistic regression analysis was used to analyze the risk factors of postoperative recurrence and metastasis in patients with advanced gastric cancer. The receiver operating characteristic curve (ROC) was drawn to analyze the predictive value ofNLR for postoperative recurrence and metastasis in patients with advanced gastric cancer after radical gastrectomy. Results: The level of NLR in the case group was significantly different from that in the healthy control group (P＜0.05). Univariate analysis showed that TNM stage, tumor differentiation, depth of invasion, postoperative radiotherapy and chemotherapy, tumor diameter and NLR were significantly different between the two groups (P＜0.05). Multivariate analysis showed that TNM stage, depth of invasion, tumor diameter and NLR were the influencing factors of postoperative recurrence and metastasis in patients with advanced gastric cancer after radical gastrectomy (P＜0.05). ROC curve showed that the area under the curve of NLR in predicting postoperative recurrence and metastasis in patients with advanced gastric cancer after radical gastrectomy was 0.732. Conclusion: NLR is highly expressed in patients with advanced gastric cancer after radical gastrectomy. As a factor affecting postoperative recurrence and metastasis, NLR has certain clinical value in predicting postoperative recurrence and metastasis.
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