淋巴细胞计数低和单核细胞计数高预示着胃癌的预后不良。
Low lymphocyte count and high monocyte count predicts poor prognosis of gastric cancer.
作者信息
Feng Fan, Zheng Gaozan, Wang Qiao, Liu Shushang, Liu Zhen, Xu Guanghui, Wang Fei, Guo Man, Lian Xiao, Zhang Hongwei
机构信息
Division of Digestive Surgery, Xijing Hospital of Digestive Diseases, Fourth Military Medical University, 127 West Changle Road, Xi'an, 710032, Shaanxi, China.
Department of General Surgery, No. 91 Hospital of PLA, Jiaozuo, 454000, Henan, China.
出版信息
BMC Gastroenterol. 2018 Oct 11;18(1):148. doi: 10.1186/s12876-018-0877-9.
BACKGROUND
Existing data about the prognostic value of absolute count of blood cells in gastric cancer was limited. Thus, the present study aims to investigate the prognostic value of absolute count of white blood cell (WBC), neutrophil, lymphocyte, monocyte and platelet in gastric cancer patients.
METHODS
From September 2008 to March 2015, 3243 patients treated with radical gastrectomy were enrolled in the present study. Clinicopathological characteristics were recorded. The prognostic value of blood test in gastric cancer patients were analyzed.
RESULTS
There were 2538 male and 705 female. The median age was 58 years (range 20-90). The median follow-up time was 24.9 months (range 1-75). The 1-, 3- and 5-year overall survival rate was 88.9%, 65.8% and 57.2%, respectively. The optimal cut off value was 6.19 × 109/L for WBC (P = 0.146), 4.19 × 109/L for neutrophil (P = 0.004), 1.72 × 109/L for lymphocyte (P = 0.000), 0.51 × 109/L for monocyte (P = 0.019) and 260.0 × 109/L for platelet (P = 0.002), respectively. Neutrophil, lymphocyte, monocyte and platelet were risk factors for the prognosis of gastric cancer (all P < 0.05). However, only lymphocyte and monocyte were independent risk factors (both P < 0.05). Combination of lymphocyte and monocyte could increase the prognostic value for gastric cancer patients, especially in stage II/III gastric cancer patients.
CONCLUSIONS
High absolute count of neutrophil, monocyte and platelet, and low absolute count of lymphocyte were associated with poor prognosis of gastric cancer. However, only lymphocyte and monocyte count were independent prognostic predictors. Combination of lymphocyte and monocyte count could further increase the predictive value for gastric cancer.
背景
关于胃癌患者血细胞绝对计数的预后价值，现有数据有限。因此，本研究旨在探讨白细胞（WBC）、中性粒细胞、淋巴细胞、单核细胞和血小板的绝对计数对胃癌患者的预后价值。
方法
2008年9月至2015年3月，3243例行根治性胃切除术的患者纳入本研究。记录临床病理特征。分析血液检查对胃癌患者的预后价值。
结果
男性2538例，女性705例。中位年龄58岁（范围20 - 90岁）。中位随访时间24.9个月（范围1 - 75个月）。1年、3年和5年总生存率分别为88.9%、65.8%和57.2%。白细胞的最佳截断值为6.19×10⁹/L（P = 0.146），中性粒细胞为4.19×10⁹/L（P = 0.004），淋巴细胞为1.72×10⁹/L（P = 0.000），单核细胞为0.51×10⁹/L（P = 0.019），血小板为260.0×10⁹/L（P = 0.002）。中性粒细胞、淋巴细胞、单核细胞和血小板是胃癌预后的危险因素（均P < 0.05）。然而，只有淋巴细胞和单核细胞是独立危险因素（均P < 0.05）。淋巴细胞和单核细胞联合可提高对胃癌患者的预后价值，尤其是在II/III期胃癌患者中。
结论
中性粒细胞、单核细胞和血小板绝对计数高以及淋巴细胞绝对计数低与胃癌预后不良相关。然而，只有淋巴细胞和单核细胞计数是独立的预后预测指标。淋巴细胞和单核细胞计数联合可进一步提高对胃癌的预测价值。
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