胃肠道间质瘤病人中性粒细胞淋巴细胞比值和血浆纤维蛋白原对预后的判断价值

doi:10.3969/j.issn.1005-6483.2020.10.016

摘要/Abstract

摘要： 目的探讨术前中性粒细胞淋巴细胞比值（NLR）以及血浆纤维蛋白原（FIB）水平对可手术胃肠道间质瘤病人预后的预测价值。
方法 2015年1月～2018年12月收治的可手术胃肠道间质瘤病人85例，均接受手术治疗，检测术前NLR及FIB，随访截止时间为2020年2月，观察NLR及FIB对无进展生存期（PFS）及总生存期（OS）影响，并分析PFS及OS影响因素，观察NLR联合FIB对胃肠道间质瘤预后的价值。
结果该组病人随访时间为14～60个月，平均随访（46.9±6.8）个月，失访5例，10例死亡。ROC曲线分析结果显示，NLR、FIB预测生存的曲线下面积为0.77、0.72，NLR联合FIB预测生存的灵敏度为68.2%，特异度为86.3%。Kaplan-Meier并Log-rank检验结果显示，高NLR组PFS及OS较低NLR组短，差异有统计学意义（P<0.05），高FIB组PFS及OS较低FIB组短，差异有统计学意义（P<0.05）。多因素Cox分析显示，NLR、FIB、肿瘤危险度是可手术胃肠道间质瘤病人PFS及OS的独立影响因素（P<0.05）。
结论 NLR、FIB升高的可手术胃肠道间质瘤病人预后较差。术前NLR、FIB水平可用于预测病人预后，且NLR联合FIB对预测胃肠道间质瘤生存率具有较高价值。

关键词: 中性粒细胞淋巴细胞比值, 纤维蛋白原, 胃肠道间质瘤, 预后

Abstract: Objective To investigate the predictive value of preoperative neutrophil lymphocyte ratio (NLR) and plasma fibrinogen (FIB) levels in the prognosis of operable gastrointestinal stromal tumors.
Methods A total of 85 patients with surgical gastrointestinal stromal tumors who were treated in Huai’an First People’s Hospital from January 2015 to December 2018 were selected.NLR and FIB were detected before surgery，and the patients were followed up.The follow-up deadline wasFebruary 2020.The effects of NLR and FIB on progression-free survival (PFS) and overall survival (OS)，the factors affecting PFS and OS，and the predictive value of NLR combined with FIB on the prognosis of surgical gastrointestinal stromal tumors were observed.
Results The follow-up time of this group of patients was 14～60 months.The average follow-up time was (46.9±6.8) months.A total of 5 patients were lost to follow-up and 10 died.The ROC curve analysis results showed that the areas under the NLR and FIB prediction survival were 0.77 and 0.72.The sensitivity of NLR combined with FIB prediction survival was 68.2% and the specificity was 86.3%.Kaplan-Meier and Log-rank test results showed that the PFS and OS of the high NLR group were shorter than that of the NLR group，and the difference was statistically significant (P<0.05).The PFS and OS of the high FIB group were shorter and the difference was statistically shorter(P<0.05).Multivariate Cox analysis showed that NLR,FIB，and tumor risk were independent factors affecting PFS and OS in patients with operable gastrointestinal stromal tumors (P<0.05).
Conclusion The prognosis of patients with operable gastrointestinal stromal tumors with elevated NLR and FIB is poor.Preoperative NLR and FIB levels can be used to predict the prognosis of patients，and NLR combined with FIB is of high value in predicting the survival rate of gastrointestinal stromal tumors.

Key words: neutrophil lymphocyte ratio, fibrinogen, gastrointestinal stromal tumor, prognosis

孙虎孙颖. 胃肠道间质瘤病人中性粒细胞淋巴细胞比值和血浆纤维蛋白原对预后的判断价值[J]. 临床外科杂志, 2020, 28(10): 951-954.

SUN Hu, SUN Ying.. Predictive value of neutrophil lymphocyte ratio and plasma fibrinogen in the prognosis of patients with gastrointestinal stromal tumors[J]. JOURNAL OF CLINICAL SURGERY, 2020, 28(10): 951-954.

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