术前和术后淋巴细胞- C 反应蛋白比值的联合分析能精确预测胃癌患者的预后。
Combined analysis of preoperative and postoperative lymphocyte-C-reactive protein ratio precisely predicts outcomes of patients with gastric cancer.
机构信息
Department of Surgery, Division of Gastrointestinal and Pediatric Surgery, School of Medicine, Tottori University Faculty of Medicine, 36-1 Nishi-cho, Yonago, 683-8504, Japan.
Department of Surgery, Japanese Red Cross Tottori Hospital, Tottori, 680‑8517, Japan.
出版信息
BMC Cancer. 2022 Jun 11;22(1):641. doi: 10.1186/s12885-022-09716-9.
BACKGROUND
The systemic inflammatory response resulting from the complex interactions between cancer and the host plays an important role in cancer development. Recently, the lymphocyte-C-reactive protein ratio (LCR), which is a hematological and biochemical marker that reflects the systemic inflammatory response and nutritional status, has been reported to be associated with poor survival. Similar results were observed in patients with certain cancer types. However, these studies focused on the preoperative LCR, and thus far, no studies have reported the relationship between postoperative LCR and prognosis in patients with gastric cancer (GC).
METHODS
This study enrolled 455 patients with a histopathological diagnosis of gastric adenocarcinoma who underwent curative surgery at our institution between 2005 and 2018. The relationship between both the preoperative and postoperative LCR and the prognosis of patients with GC was retrospectively investigated.
RESULTS
Preoperative LCR showed significant correlations with tumor-related factors, such as tumor size, depth of invasion, and lymph node metastasis. By contrast, no correlation was observed between postoperative LCR and tumor-related factors. The 5 year survival rate was significantly worse in patients with low preoperative LCR than in those with high preoperative LCR (65.4% vs. 83.9%, p < 0.0001). Similarly, the 5 year survival rate was also significantly worse in patients with low postoperative LCR than in those with high postoperative LCR (67.0% vs. 84.1%, p < 0.0001). Furthermore, combination analysis of the pre- and postoperative LCR revealed that the prognosis of patients with both low pre- and postoperative LCR was worse in patients with GC (5 year survival rate was 52.0%). A multivariate analysis indicated that a low pre- and postoperative LCR and age and lymph node metastasis were independent prognostic indicators.
CONCLUSIONS
The combination of preoperative and postoperative LCR appears to be useful in predicting the prognosis of patients with GC.
背景
癌症与宿主之间复杂相互作用导致的全身炎症反应在癌症发展中起重要作用。最近，淋巴细胞- C 反应蛋白比值（LCR）作为反映全身炎症反应和营养状况的血液学和生化标志物，已被报道与不良预后相关。在某些癌症类型的患者中也观察到了类似的结果。然而，这些研究集中在术前 LCR，迄今为止，尚无研究报道胃癌（GC）患者术后 LCR 与预后的关系。
方法
本研究纳入了 2005 年至 2018 年在我院接受根治性手术治疗的 455 例组织学诊断为胃腺癌的患者。回顾性研究了术前和术后 LCR 与 GC 患者预后的关系。
结果
术前 LCR 与肿瘤相关因素（如肿瘤大小、浸润深度和淋巴结转移）有显著相关性。相比之下，术后 LCR 与肿瘤相关因素无相关性。术前 LCR 低的患者 5 年生存率明显低于术前 LCR 高的患者（65.4%比 83.9%，p<0.0001）。同样，术后 LCR 低的患者 5 年生存率也明显低于术后 LCR 高的患者（67.0%比 84.1%，p<0.0001）。此外，术前和术后 LCR 的联合分析显示，GC 患者同时存在术前和术后 LCR 低的患者预后更差（5 年生存率为 52.0%）。多因素分析表明，低术前和术后 LCR 以及年龄和淋巴结转移是独立的预后指标。
结论
术前和术后 LCR 的联合似乎有助于预测 GC 患者的预后。
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