Preoperative platelet-to-lymphocyte count ratio predicts peritoneal metastasis in patients with advanced gastric cancer

中华普通外科杂志 Pub Date : 2019-10-25 DOI:10.3760/CMA.J.ISSN.1007-631X.2019.10.002

Wenyang Pang, Wen-Jing Chen, G. Zhu, Changyuan Hu, Yiqi Cai

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Abstract

Objective To assess the predictive value of the platelet-to-lymphocyte ratio(PLR), neutrophil-to-lymphocyte ratio(NLR)and tumor-related factors on the peritoneal metastasis in advanced gastric cancer patients. Methods A total of 701 pathologically confirmed gastric cancer patients who underwent surgery at the First Affiliated Hospital of Wenzhou Medical University between Jan 2009 and Jan 2012 were enrolled. Results Univariate analysis indicated that tumor location, tumor size, serosal invasion, depth of invasion, pathological type, lymph node metastasis and PLR were related to peritoneal metastasis(all P<0.05). According to the area under the ROC curve, the optimal cutoff value of PLR for predicting peritoneal metastasis was 132.43 (sensitivity 71.8%, specificity 50.6%). There were significant differences in tumor size, TNM stage, lymph node metastasis and serosal infiltration between high PLR group and low PLR group. Multivariate Logistic analyses revealed that PLR (HR=2.205, P=0.003), lymph node metastasis(HR=3.113, P=0.010)and tumor size(HR=1.150, P=0.014) were independent risk factors for peritoneal metesfasis. Conclusions Preoperative PLR is valuable in predicting peritoneal metastasis of advanced gastric cancer and it is an independent risk factor for peritoneal metastasis of gastric cancer. Key words: Stomach neoplasms; Platelet; Lymphocyte; Neoplasm metastasis

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术前血小板/淋巴细胞计数比预测晚期胃癌患者腹膜转移

目的探讨血小板与淋巴细胞比值(PLR)、中性粒细胞与淋巴细胞比值(NLR)及肿瘤相关因素对晚期胃癌腹膜转移的预测价值。方法选取2009年1月至2012年1月在温州医科大学附属第一医院行手术的经病理证实的胃癌患者701例。结果单因素分析显示，肿瘤位置、肿瘤大小、浆膜浸润、浸润深度、病理类型、淋巴结转移及PLR与腹膜转移相关(均P<0.05)。根据ROC曲线下面积，PLR预测腹膜转移的最佳截止值为132.43(敏感性71.8%，特异性50.6%)。高PLR组与低PLR组在肿瘤大小、TNM分期、淋巴结转移及浆膜浸润方面均有显著差异。多因素Logistic分析显示，PLR (HR=2.205, P=0.003)、淋巴结转移(HR=3.113, P=0.010)和肿瘤大小(HR=1.150, P=0.014)是腹膜外系膜的独立危险因素。结论术前PLR对预测晚期胃癌腹膜转移有重要价值，是胃癌腹膜转移的独立危险因素。关键词:胃肿瘤;血小板;淋巴细胞;肿瘤转移

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中华普通外科杂志

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