Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou 350001, Fujian Province, China.
World J Gastroenterol. 2017 Dec 21;23(47):8376-8386. doi: 10.3748/wjg.v23.i47.8376.
To assess the predictive value of the tumor-associated neutrophil-to-lymphocyte ratio in terms of the clinical outcomes of patients with gastric neuroendocrine neoplasms after radical surgery.
Data were retrospectively collected from 142 patients who were diagnosed with gastric neuroendocrine neoplasms and who underwent radical gastrectomy at our department from March 2006 to March 2015. These data were retrospectively analyzed, and a receiver operating characteristic curve analysis was used to identify the optimal value of the tumor-associated neutrophil-to-lymphocyte ratio. Univariate and multivariate survival analyses were used to identify prognostic factors. A nomogram was then applied to predict clinical outcomes after surgery.
The tumor-associated neutrophil-to-lymphocyte ratio was significantly associated with tumor recurrence, especially with liver metastasis and lymph node metastasis ( < 0.05 for both), but not with clinical characteristics ( > 0.05 for all). A multivariate Cox regression analysis identified the tumor-associated neutrophil-to-lymphocyte ratio as an independent prognostic factor for recurrence-free survival and overall survival ( < 0.05 for both). The concordance index of the nomograms, which included the tumor-associated neutrophil-to-lymphocyte ratio, Ki-67 index, and lymph node ratio, was 0.788 (0.759) for recurrence-free survival (overall survival) and was higher than the concordance index of the traditional TNM staging system [0.672 (0.663)].
The tumor-associated neutrophil-to-lymphocyte ratio is an independent prognostic factor in patients with gastric neuroendocrine neoplasms. Nomograms that include the tumor-associated neutrophil-to-lymphocyte ratio, Ki-67 index, and lymph node ratio have a superior ability to predict clinical outcomes of postoperative patients.
评估肿瘤相关中性粒细胞与淋巴细胞比值对根治性手术后胃神经内分泌肿瘤患者临床结局的预测价值。
回顾性收集了 2006 年 3 月至 2015 年 3 月在我院接受根治性胃切除术的 142 例胃神经内分泌肿瘤患者的数据。对这些数据进行回顾性分析，并使用受试者工作特征曲线分析确定肿瘤相关中性粒细胞与淋巴细胞比值的最佳值。使用单因素和多因素生存分析来确定预后因素。然后应用列线图预测术后临床结局。
肿瘤相关中性粒细胞与淋巴细胞比值与肿瘤复发显著相关，尤其是与肝转移和淋巴结转移相关（两者均 < 0.05），但与临床特征无关（两者均 > 0.05）。多因素 Cox 回归分析发现，肿瘤相关中性粒细胞与淋巴细胞比值是无复发生存和总生存的独立预后因素（两者均 < 0.05）。包括肿瘤相关中性粒细胞与淋巴细胞比值、Ki-67 指数和淋巴结比率的列线图的一致性指数为 0.788（无复发生存）（0.759）（总生存），高于传统 TNM 分期系统的一致性指数[0.672（无复发生存）（0.663）]。
肿瘤相关中性粒细胞与淋巴细胞比值是胃神经内分泌肿瘤患者的独立预后因素。包括肿瘤相关中性粒细胞与淋巴细胞比值、Ki-67 指数和淋巴结比率的列线图在预测术后患者临床结局方面具有更高的能力。
