摘要
目的评价围术期中性粒细胞/淋巴细胞比值(NLR)与进展期胃癌患者术后早期复发的关系。方法本研究为前瞻性研究。选择2018年1月至2022年4月在河北医科大学第四医院择期全身麻醉下行胃癌根治术的进展期胃癌患者188例,ASA分级Ⅰ或Ⅱ级,年龄18~75岁,BMI 20~30 kg/m^(2),影像学分期为T_(2-4)N_(x)M_(0)。于术前1 d、术后第1天、术后第3天和术后第5天采用半导体激光器流式细胞计数法测定NLR,计算术后与术前NLR的差值(ΔNLR)。根据患者术后2年内是否存在肿瘤复发和(或)转移,将患者分为复发组和未复发组。采用Cox比例风险回归模型评价进展期胃癌患者术后早期复发与围术期NLR的关系。结果最终171例患者完成随访。复发组77例,未复发组94例。与未复发组比较,复发组术后第5天NLR和ΔNLR升高(P<0.05)。术后第5天NLR和ΔNLR升高是进展期胃癌患者术后2年内复发的独立危险因素(HR=1.026,P<0.05)。结论围术期NLR水平可能与进展期胃癌患者术后早期复发无关,尚需大样本研究进一步评价。
ObjectiveTo evaluate the relationship between the neutrophil-to-lymphocyte ratio(NLR)during the perioperative period and early postoperative recurrence in patients with advanced gastric cancer.MethodsIn this prospective study,188 American Society of Anesthesiologists Physical Status classificationⅠorⅡpatients,aged 18-75 yr,with a body mass index of 20-30 kg/m^(2),with radiological staging of T_(2-4)N_(x)M_(0),underwent elective gastric cancer radical surgery under general anesthesia at the Fourth Hospital of Hebei Medical University from January 2018 to April 2022,were selected.The NLR was measured at 1 day before operation and postoperative days 1,3 and 5.The difference between postoperative and preoperative NLR(ΔNLR)was calculated.Based on the presence or absence of tumor recurrence and/or metastasis within 2 yr after surgery,the patients were divided into recurrence group and non-recurrence group.The Cox proportional hazards regression model was employed to evaluate the early postoperative recurrence and perioperative NLR in patients with advanced gastric cancer.ResultsA total of 171 patients ultimately completed the follow-up.There were 77 cases in recurrence group and 94 in non-recurrence group.Compared to non-recurrence group,NLR andΔNLR were significantly increased on the 5th day after operation in recurrence group(P<0.05).The elevated NLR andΔNLR at postoperative day 5 were independent risk factors for recurrence within 2 yr in patients with advanced gastric cancer(HR=1.026,P<0.05).ConclusionsNLR may not be associated with the risk of early postoperative recurrence in the patients with advanced gastric cancer,and further evaluation with large-scale studies is needed.
作者
雍芳芳
刘微
贾卫爱
王合梅
王之骄
贾慧群
Yong Fangfang;Liu Wei;Jia Weiai;Wang Hemei;Wang Zhijiao;Jia Huiqun(Department of Anesthesiology,Fourth Hospital of Hebei Medical University,Shijiazhuang 050011,China)
出处
《中华麻醉学杂志》
北大核心
2025年第6期694-697,共4页
Chinese Journal of Anesthesiology
基金
河北省卫生健康委医学科学研究指令性课题(20230145)。
关键词
中性白细胞
淋巴细胞
胃肿瘤
复发
Neutrophils
Lymphocytes
Stomach neoplasms
Recurrence
