Pan Yu-Chen, Jia Zhi-Fang, Cao Dong-Hui, Wu Yan-Hua, Jiang Jing, Wen Si-Min, Zhao Dan, Zhang Song-Ling, Cao Xue-Yuan
Division of Clinical Research.
Department of Gynecological Oncology.
Medicine (Baltimore). 2018 Dec;97(52):e13896. doi: 10.1097/MD.0000000000013896.
Preoperational hemogram parameters have been reported to be associated with the prognosis of several types of cancers. This study aimed to investigate the prognostic value of hematological parameters in gastric cancer in a Chinese population. A total of 870 gastric cancer patients who underwent radical tumorectomy were recruited from January 2008 to December 2012. Preoperative hematological parameters were recorded and dichotomized by time-dependent receiver operating characteristic curves. The survival curves of patients stratified by each hematological parameter were plotted by the Kaplan-Meier method and compared by log-rank test. Multivariate Cox proportional hazards models were used to select parameters independently correlated with prognosis. The median age of the patients was 60 years. The median follow-up time was 59.9 months, and the 5-year survival rate was 56.4%. Results from the univariate analyses showed that low lymphocyte count (<2.05 × 10/L), high neutrophil-to-white blood cell ratio (NWR > 0.55), low lymphocyte-to-white blood cell ratio (LWR < 0.23), low lymphocyte-to-monocyte ratio (LMR < 5.43), high neutrophil-to-lymphocyte ratio (NLR > 1.44), and high platelet-to-lymphocyte ratio (PLR > 115) were associated with poor survival of gastric cancer patients. Multivariate analysis showed that low LMR (HR: 1.49, 95% CI: 1.17-1.89, P = .001) was the only hematological factor independently predicting poor survival. These results indicate that preoperational LMR is an independent prognostic factor for patients with resectable gastric cancer.
术前血常规参数已被报道与多种癌症的预后相关。本研究旨在探讨血液学参数对中国人群胃癌的预后价值。2008年1月至2012年12月,共招募了870例行根治性肿瘤切除术的胃癌患者。记录术前血液学参数,并通过时间依赖性受试者工作特征曲线进行二分法分析。采用Kaplan-Meier法绘制按各血液学参数分层的患者生存曲线,并通过对数秩检验进行比较。使用多变量Cox比例风险模型选择与预后独立相关的参数。患者的中位年龄为60岁。中位随访时间为59.9个月,5年生存率为56.4%。单因素分析结果显示,低淋巴细胞计数(<2.05×10/L)、高中性粒细胞与白细胞比值(NWR>0.55)、低淋巴细胞与白细胞比值(LWR<0.23)、低淋巴细胞与单核细胞比值(LMR<5.43)、高中性粒细胞与淋巴细胞比值(NLR>1.44)和高血小板与淋巴细胞比值(PLR>115)与胃癌患者的不良生存相关。多变量分析显示,低LMR(HR:1.49,95%CI:1.17-1.89,P=.001)是唯一独立预测不良生存的血液学因素。这些结果表明,术前LMR是可切除胃癌患者的独立预后因素。