术前中性粒细胞对淋巴细胞比值与晚期胃癌临床病理特点关系的研究

目的:探讨中性粒细胞对淋巴细胞比值(N/L比值)与晚期胃癌临床病理特点的关系。方法:收集2004年4月至2007年8月间的293名TNM III,IV期行手术治疗的胃癌病例的临床病理资料,结合N/L比值进行分析。N/L比值通过术前血常规检查中性粒细胞和淋巴细胞计数计算得出。结果:高NLR组IV期病例,R2切除和联合脏器切除的比例更高,肿瘤直径更大,差别具有显著性(P=0.017,0.007,0.001),而年龄,伴随疾病,肿瘤部位,Bormann分型,病理分级,Lauren分型,淋巴血管侵犯和术后化疗情况在两组间无明显差异。N/L比值在III,IV期胃癌病例中差别具有显著性(P=0.018)。结论:术前N/L比值跟晚期胃癌分期,手术根治程度相关,N/L比值升高提示分期偏晚。N/L比值可以作为一个简单可信的预后指标用来指导胃癌术后风险评估和治疗选择。

Preoperative Neutrophil to Lymphocyte Ratio is Associated withClinicopathologic Features in Late Stage Gastric Cancer

Objective: To investigate the association between Preoperative Neutrophil to Lymphocyte Ratio(N/L ratio) and the clinicopathologic features in Late Stage Gastric Cancer.Methods: From April 2004 to August 2007,293 patients who had undergone gas-trectomy with curative intent for the AJCC/UICC TNM Stage III or IV gastric cancer were included.N/L ratio was calculated from lym-phocyte and neutrophil counts on routine blood tests taken prior to surgery.Results: WBC and neutrophils increased with cancer stage,conversely lymphocytes decreased with stage.The N/L ratios in Stage IV were statistically higher than in Stage III(P= 0.018).The pa-tients of high NLR group had a more advanced stage(proportion of Stage IV in high NLR group vs.low NLR group,58.1% vs.43.5%;P= 0.017),therefore they received higher rate of R2 resection and combined resection and had a larger tumor size than the patient of low NLR group.Conclusion: Preoperative Neutrophil to Lymphocyte Ratio is associated with clinicopathologic features and the elevated pre-operative NLR predicts poor prognosis in patients undergoing potentially curative resection for late stage gastric cancer.