2018 年第 12 期 第 13 卷

胃癌患者中性粒细胞与淋巴细胞比值及血小板与淋巴细胞比值的变化及临床意义

Clinical significance of neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio in gastric cancer patients

作者：李祯张之芬韩静颖刘天璞李丽王子娥鞠瑛

英文作者：

单位：250021济南，山东大学附属省立医院临床医学检验部

英文单位：

关键词：胃肿瘤；中性粒细胞与淋巴细胞比值；血小板与淋巴细胞比值；癌胚抗原；糖类抗原

英文关键词：

• 摘要：

• 【摘要】目的    探讨胃癌患者中性粒细胞与淋巴细胞比值(NLR)及血小板与淋巴细胞比值(PLR)的变化及临床意义。方法    选取2015年7月至2017年6月在山东大学附属省立医院治疗的胃癌患者共224例（胃癌组）和同期健康体检者135名（健康对照组）。清晨空腹抽血，检测NLR、PLR、血清癌胚抗原、糖类抗原199和糖类抗原724水平。利用受试者工作特征(ROC)曲线评价NLR和PLR对胃癌的诊断价值。结果    胃癌组NLR和PLR均明显高于健康对照组，差异均有统计学意义［2.79（1.65,6.43）比1.70（1.36,2.13），176.15（123.64,246.35）比119.38（92.74,142.33）］（均P<0.001）。通过ROC曲线确定NLR和PLR最佳截点，将胃癌患者分为低NLR组（NLR<2.975）和高NLR组（NLR≥2.975）、低PLR组（PLR<157.74）和高PLR组（NLR≥157.74）。高NLR组糖类抗原724水平明显高于低NLR组［5.63（2.40,17.72）kU/L比1.81（1.13,5.94）kU/L］（P＝0.003），癌胚抗原和糖类抗原199水平差异无统计学意义（P>0.05）。高PLR组糖类抗原724水平明显高于低PLR组［5.13（1.97,16.49）kU/L比1.85（1.20,7.05）kU/L］（P=0.040），癌胚抗原和糖类抗原199水平差异无统计学意义（P>0.05）。结论    胃癌患者的NLR和PLR显著高于正常人群，高NLR和PLR患者糖类抗原724水平显著升高，提示NLR和PLR在胃癌辅助诊断中有重要意义。

• 【Abstract】Objective    To investigate the clinical significance of neutrophil-to-lymphocyte ratio(NLR) and platelet-to-lymphocyte ratio(PLR) in gastric cancer patients. Methods    From July 2015 to June 2017, 224 patients with gastric cancer and 135 healthy people were enrolled in Shandong Provincial Hospital Affiliated to Shandong University. Fasting blood was taken in the morning and NLR, PLR, carcinoembryonic antigen（CEA）, carbohydrate antigen（CA）199, CA724 were tested. Diagnostic values of NLR and PLR for gastric cancer were analyzed using receiver operating characteristic(ROC) curve. Results    NLR and PLR in gastric cancer group were significantly higher than those in healthy control group［2.79（1.65,6.43） vs 1.70（1.36,2.13）; 176.15（123.64,246.35） vs 119.38（92.74,142.33）］（P<0.001）. According to the optimum cut point of ROC curve, gastric cancer patients were divided into low NLR group(NLR<2.975) and high NLR group (NLR>2.975), low PLR group(PLR<157.74) and high PLR group(PLR>157.74). CA724 level in the high NLR group was signifi-cantly higher than that in the low NLR group［5.63（2.40,17.72）kU/L vs 1.81（1.13,5.94）kU/L］（P＝0.003）; CEA and CA199 showed no significant difference between groups(P>0.05). CA724 level in the high PLR group was significantly higher than that in the low PLR group［5.13（1.97,16.49）kU/L vs 1.85（1.20,7.05）kU/L］（P=0.040）; CEA and CA199 showed no significant difference(P>0.05). Conclusions    NLR and PLR increase in gastric cancer patients. CA724 increases in patients with high NLR and PLR.