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血小板源性炎症指标在胃癌患者中的预后意义

Prognostic Significance of Platelet-Based Inflammatory Indicators in Patients with Gastric Cancer.

作者信息

Saito Hiroaki, Kono Yusuke, Murakami Yuki, Shishido Yuji, Kuroda Hirohiko, Matsunaga Tomoyuki, Fukumoto Yoji, Osaki Tomohiro, Ashida Keigo, Fujiwara Yoshiyuki

机构信息

Division of Surgical Oncology, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, 36-1 Nishi-cho, Yonago, 683-8504, Japan.

出版信息

World J Surg. 2018 Aug;42(8):2542-2550. doi: 10.1007/s00268-018-4527-8.

Abstract

BACKGROUND

Thrombocytosis develops in association with malignant tumors and may reflect the inflammation status in cancer patients. This study retrospectively investigated the prognostic significance of two platelet-based inflammatory indicators, the platelet × C-reactive protein multiplier value (P-CRP), and platelet-lymphocyte ratio (PLR), in gastric cancer patients.

METHODS

The 453 enrolled patients had a histopathological diagnosis of gastric adenocarcinoma and underwent curative surgery.

RESULTS

P-CRP correlated significantly with age, tumor size, depth of invasion, lymph node metastasis, and disease stage. A high PLR correlated significantly with tumor size, depth of invasion, lymph node metastasis, lymphatic involvement, venous involvement, and disease stage. In the ROC analysis, the optimal cutoff value of P-CRP and PLR was 3.689 and 173.3, respectively. Five-year survival rates were 62.9 and 82.1% in patients with P-CRP (≥3.689) and P-CRP (<3.698), respectively (P < 0.0001). Five-year survival rates were 66.3 and 81.3% in patients with PLR (≥173.3) and PLR (<173.3), respectively (P = 0.0022). The prognosis of the P-CRP/PLR group was significantly worse than that of the P-CRP or PLR and P-CRP/PLR groups in terms of overall survival (P < 0.0001) and disease-specific survival (P = 0.029). In a multivariate analysis, the combination of P-CRP and PLR was an independent prognostic indicator.

CONCLUSIONS

The combination of P-CRP and PLR may be useful in predicting prognosis in gastric cancer patients.

摘要

背景

血小板增多症与恶性肿瘤相关,可能反映癌症患者的炎症状态。本研究回顾性调查了两种基于血小板的炎症指标,即血小板×C反应蛋白乘积值(P-CRP)和血小板淋巴细胞比值(PLR)对胃癌患者的预后意义。

方法

453例入组患者经组织病理学诊断为胃腺癌并接受了根治性手术。

结果

P-CRP与年龄、肿瘤大小、浸润深度、淋巴结转移及疾病分期显著相关。高PLR与肿瘤大小、浸润深度、淋巴结转移、淋巴管受累、静脉受累及疾病分期显著相关。在ROC分析中,P-CRP和PLR的最佳截断值分别为3.689和173.3。P-CRP(≥3.689)和P-CRP(<3.698)患者的5年生存率分别为62.9%和82.1%(P<0.0001)。PLR(≥173.3)和PLR(<173.3)患者的5年生存率分别为66.3%和81.3%(P=0.0022)。在总生存期(P<0.0001)和疾病特异性生存期(P=0.029)方面,P-CRP/PLR组的预后明显差于P-CRP或PLR组。在多变量分析中,P-CRP和PLR的联合是一个独立的预后指标。

结论

P-CRP和PLR的联合可能有助于预测胃癌患者的预后。

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