本文選題：胃癌 + 中性粒細胞與淋巴細胞比值　； 參考：《福建中醫(yī)藥大學》2017年碩士論文

【摘要】：目的:研究胃癌患者術(shù)前中性粒細胞與淋巴細胞比值(Neutrophil-to-Lymphocyte Ratio,NLR)與腫瘤各預后因子之間的關(guān)系,探討胃癌患者術(shù)前NLR對預后轉(zhuǎn)歸的評估價值,進而指導臨床治療。方法:選擇自2013年1月至2013年12月在莆田學院附屬醫(yī)院行胃癌根治術(shù)治療的122例患者病例資料進行回顧性研究,其中男90例,女32例,平均年齡60.8歲。收集患者術(shù)前中性粒細胞計數(shù)、淋巴細胞計數(shù),根據(jù)所得數(shù)據(jù)計算患者NLR值。查閱大量海內(nèi)外文獻資料后,以NLR臨界值為2.5,將上述合格病例分為高NLR組和低NLR組,分析NLR值與患者年紀、性別、病理類別、腫瘤大小、浸潤深度、淋巴結(jié)轉(zhuǎn)移、TNM分期、HER-2基因等各因子之間的關(guān)系,并對患者術(shù)后進行隨訪,評估NLR值對胃癌預后的臨床價值。結(jié)果:1.單因素分析術(shù)前NLR值與臨床各因子提示:術(shù)前NLR值高低與患者年紀、淋巴結(jié)轉(zhuǎn)移、腫瘤浸潤深度、TNM分期及HER-2之間差別具有統(tǒng)計學定見(P0.05),NLR值越高,年紀越大、淋巴結(jié)擴散的可能性越大、TNM分期越晚;HER-2陽性患者NLR值較HER-2陰性患者高。而性別、病理類別、腫瘤大小與NLR值之間無確切相關(guān)(P0.05)。進一步Logisitic多因素回歸分析顯示:胃癌患者年紀、浸潤深度、淋巴結(jié)轉(zhuǎn)移、TNM分期、HER-2與術(shù)前NLR值密切關(guān)聯(lián)(P0.05)。2.腫瘤浸潤深度、TNM分期、淋巴結(jié)擴散、HER-2、術(shù)前NLR值對患者術(shù)后轉(zhuǎn)歸有重要定見(P0.05),年紀、性別、腫瘤大小、病理分化類別與患者術(shù)后轉(zhuǎn)歸無確切關(guān)聯(lián)(P0.05)。低NLR組患者3年存活率明顯優(yōu)于高NLR組病人(P=0.011),HER-2陰性患者預后好于HER-2陽性患者(P=0.02);腫瘤浸潤深度越深(P=0.000)、TNM分期越晚(P=0.000)、淋巴結(jié)轉(zhuǎn)移越多(P=0.006),患者3年生存率越低。結(jié)論:1.術(shù)前NLR水平可能與年紀、淋巴結(jié)擴散、腫瘤浸潤深度、TNM分期及HER-2緊密相關(guān)。2.術(shù)前NLR、腫瘤浸潤深度、TNM分期、淋巴結(jié)擴散可能對患者預后有重要意義。3.術(shù)前NLR或許可以成為胃癌轉(zhuǎn)歸的一種簡便有用的評估標志物。
[Abstract]:Objective: to study the relationship between neutrophil-to-Lymphocyte Ratiophocyte NLR- (NLR-) and tumor prognostic factors in patients with gastric cancer before operation, and to explore the value of preoperative NLR in evaluating prognosis and prognosis in patients with gastric cancer, so as to guide clinical treatment. Methods: from January 2013 to December 2013, 122 patients with gastric cancer treated by radical gastrectomy in Putian University Hospital were retrospectively studied, including 90 males and 32 females, with an average age of 60.8 years. Neutrophil count and lymphocyte count were collected and NLR values were calculated. According to the critical value of NLR was 2.5, the patients were divided into high NLR group and low NLR group. The NLR value and age, sex, pathological type, tumor size, depth of invasion were analyzed. The relationship between HER-2 gene and TNM staging of lymph node metastasis was evaluated. The clinical value of NLR in the prognosis of gastric cancer was evaluated. The result is 1: 1. Univariate analysis of preoperative NLR values and clinical factors suggested that preoperative NLR values were significantly different between preoperative NLR values and patient age, lymph node metastasis, TNM stage of tumor invasion depth and HER-2. The higher the NLR value was, the higher the NLR value was and the older the patient was. The higher the probability of lymph node diffusion, the higher the NLR value in HER-2 positive patients with TNM stage. However, there was no positive correlation between sex, pathological type, tumor size and NLR value (P 0.05). Further Logisitic multivariate regression analysis showed that age, depth of invasion, lymph node metastasis, TNM staging and HER-2 were closely correlated with preoperative NLR value (P0.05. 2). TNM stage, lymph node diffusion (HER-2), preoperative NLR value were important for postoperative outcome (P0.05), age, sex, tumor size, pathological differentiation type had no definite correlation with postoperative outcome (P0.05). The 3-year survival rate of low NLR group was significantly better than that of HER-2 negative patients with high NLR, and the deeper the depth of tumor invasion was, the later the TNM stage was, the more lymph node metastasis was, the lower the 3-year survival rate was. Conclusion 1. Preoperative NLR levels may be closely related to age, lymph node diffusion, depth of tumor invasion, TNM stage and HER-2. Preoperative NLR, depth of tumor invasion and TNM stage, lymph node diffusion may have important significance for prognosis of patients. Preoperative NLR may be a simple and useful marker for evaluating the outcome of gastric cancer.
【學位授予單位】：福建中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R735.2

【參考文獻】

相關(guān)期刊論文 前10條

1 邢藝;趙明峰;;粒細胞集落刺激因子受體突變和髓系腫瘤發(fā)生[J];中國醫(yī)學科學院學報;2016年01期

2 尹洪巖;王艷榮;陳楊;李晨曦;石燕;戴廣海;;外周血中性粒細胞與淋巴細胞比值對Ⅳ期胃癌化療患者預后的意義[J];解放軍醫(yī)學院學報;2016年03期

3 劉濤;李燕京;韓宇;;HER2在胃癌中的研究進展[J];現(xiàn)代腫瘤醫(yī)學;2015年15期

4 鐘啟寶;張海林;楊明;劉平;易恩歡;楊嶷芳;;術(shù)前外周血中性粒細胞/淋巴細胞比值與喉癌患者預后的關(guān)系[J];中國耳鼻咽喉顱底外科雜志;2015年02期

5 李斌;李玉民;郭繼武;魏育才;;幽門螺桿菌與胃癌相關(guān)機制的研究進展[J];世界華人消化雜志;2015年07期

6 張慶勇;羅春華;王群興;;腫瘤相關(guān)中性粒細胞的研究新進展[J];細胞與分子免疫學雜志;2014年10期

7 吳介恒;楊安鋼;溫偉紅;;PD-1/PD-L1參與腫瘤免疫逃逸的研究進展[J];細胞與分子免疫學雜志;2014年07期

8 江慧;宋純;張桂榮;李奕;袁野;;HER2陽性胃癌臨床病理特征分析[J];中國腫瘤;2014年05期

9 齊京鵬;常彥祥;李斌;李曉華;李小颯;呂麗芬;;胃癌患者術(shù)前炎癥標志物檢測在患者預后評估中的意義[J];現(xiàn)代腫瘤醫(yī)學;2014年04期

10 暢智慧;鄭加賀;王傳卓;趙健;馬羽佳;劉兆玉;;中性粒細胞與淋巴細胞比值對結(jié)腸癌肝轉(zhuǎn)移射頻消融術(shù)后腫瘤復發(fā)的影響[J];現(xiàn)代腫瘤醫(yī)學;2014年05期

，

本文編號：2045023