Xu Zhengshui, Cheng Hua
Department of Gastrointestinal Surgery, The Second Affiliated hospital to Nanchang University, Nanchang 330006, China.
Zhonghua Wei Chang Wai Ke Za Zhi. 2017 Feb 25;20(2):236-240.
Gastric cancer (GC) is one of the most common tumor in the world, and remains a major public health problem and one of the leading causes of death. Recently many researches have demonstrated that systemic inflammatory response is associated with prognosis and response to therapy in gastric cancer, and the peripheral blood count test can partly reflect the systemic inflammatory response. Based on the peripheral blood count test, there are a lot of research regarding the relation between the platelet count (PLT), neutrophil, lymphocyte, white blood cell (WBC), neutrophil to lymphocyte ratio(NLR), platelet to lymphocyte ratio (PLR) with their prognostic role in gastric cancer. A high PLT and preoperative lymphocytopenia are both associated with increased lymph node metastasis, stage (III(+IIII(), serosal invasion (T3+T4) risk and poorer overall survival. Besides above, platelet monitoring following surgery can be applied to predict the recurrence for patients with GC that suffer preoperative high PLT but have restored PLT levels following resection. Moreover systemic inflammatory factors based on blood parameters, such as PLR, NLR and so on, have relation with the poor prognosis of patients with GC. Among them, high NLR is a negative predictor of prognosis in GC patients. However PLR remains inconsistent, while most researches demonstrated high PLR may be useful prognostic factor rather than independent prognostic factor. There are still some limitations which include various cut-off values, little of clinician attention, the uncertain mechanism, etc. Here we review the research progress in the prognostic role of the blood count test in gastric cancer.
胃癌（GC）是世界上最常见的肿瘤之一，仍然是一个重大的公共卫生问题和主要死因之一。最近许多研究表明，全身炎症反应与胃癌的预后及对治疗的反应相关，而外周血细胞计数检测可部分反映全身炎症反应。基于外周血细胞计数检测，有许多关于血小板计数（PLT）、中性粒细胞、淋巴细胞、白细胞（WBC）、中性粒细胞与淋巴细胞比值（NLR）、血小板与淋巴细胞比值（PLR）与它们在胃癌中的预后作用之间关系的研究。高PLT和术前淋巴细胞减少均与淋巴结转移增加、分期（III（+IV））、浆膜侵犯（T3+T4）风险及较差的总生存期相关。除此之外，术后血小板监测可用于预测术前PLT高但切除后PLT水平恢复的GC患者的复发情况。此外，基于血液参数的全身炎症因子，如PLR、NLR等，与GC患者的不良预后有关。其中，高NLR是GC患者预后的负性预测指标。然而，PLR的情况仍不一致，虽然大多数研究表明高PLR可能是一个有用的预后因素而非独立的预后因素。仍存在一些局限性，包括各种临界值、临床医生关注较少、机制不明等。在此，我们综述血细胞计数检测在胃癌预后作用方面的研究进展。
