Zhou Xin, Xu Lei, Huang Zebo, Zhang Lan, Zhang Huo, Zhu Wei, Liu Ping
Department of Oncology, First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China.
Department of Thoracic Surgery, The Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing, Jiangsu, China.
Cancer Biomark. 2016 Sep 26;17(3):359-367. doi: 10.3233/CBM-160648.
Recently, many studies have investigated the value of the hematologic markers in the prognosis of gastric cancer (GC). However, most studies only focused on the pre-operative markers. The aim of this study was to investigate the prognostic value of the hematologic markers of resectable GC patients at three different periods of the treatment (preoperative, postoperative and before the first chemotherapy).
Clinical data from 451 GC patients were retrospectively collected. Hematologic markers including leukocyte, neutrophil, lymphocyte, red blood cell (RBC), platelet, mean platelet volume (MPV), neutrophil proportion (NP), lymphocyte proportion (LP), neutrophil lymphocyte ratio (NLR), and platelet lymphocyte ratio (PLR) were adopted as potential prognostic biomarkers. The Kaplan-Meier method and Cox regression model were applied to reveal the prognostic significance of the hematologic markers.
Preoperative PLR was independently associated with overall survival (OS) via multivariate analysis (hazard ratio, 1.399; 95% confidence interval, 1.015-1.928; p = 0.04). Elevated PLR predicted a larger tumor size (P< 0.001), deeper tumor invasion (P= 0.035) and elevated level of CEA (P= 0.012).
Although only high preoperative PLR could serve as an independent unfavorable prognostic factor, other markers such as preoperative and postoperative NLR could also provide additionally prognostic information.
最近，许多研究探讨了血液学标志物在胃癌（GC）预后中的价值。然而，大多数研究仅关注术前标志物。本研究的目的是探讨可切除胃癌患者在治疗的三个不同时期（术前、术后和首次化疗前）血液学标志物的预后价值。
回顾性收集451例胃癌患者的临床资料。采用包括白细胞、中性粒细胞、淋巴细胞、红细胞（RBC）、血小板、平均血小板体积（MPV）、中性粒细胞比例（NP）、淋巴细胞比例（LP）、中性粒细胞淋巴细胞比值（NLR）和血小板淋巴细胞比值（PLR）等血液学标志物作为潜在的预后生物标志物。应用Kaplan-Meier法和Cox回归模型揭示血液学标志物的预后意义。
通过多变量分析，术前PLR与总生存期（OS）独立相关（风险比，1.399；95%置信区间，1.015-1.928；P = 0.04）。PLR升高预示肿瘤体积更大（P < 0.001）、肿瘤浸润更深（P = 0.035）和癌胚抗原水平升高（P = 0.012）。
虽然只有术前高PLR可作为独立的不良预后因素，但其他标志物如术前和术后NLR也可提供额外的预后信息。
