| 李志强,陈 军,丁国崇.单核细胞和淋巴细胞比值、改良格拉斯哥预后评分与进展期胃癌患者胃癌根治术后预后的关系研究[J].,2025,(18):2965-2972 |
| 单核细胞和淋巴细胞比值、改良格拉斯哥预后评分与进展期胃癌患者胃癌根治术后预后的关系研究 |
| Study on the Relationship between Monocyte-Lymphocyte Ratio, Modified Glasgow Prognostic Score and the Prognosis of Patients with Advanced Gastric Cancer after Radical Gastrectomy |
| 投稿时间：2025-03-28 |
| DOI：10.13241/j.cnki.pmb.2025.18.012 |
| 中文关键词: 进展期胃癌 胃癌根治术 单核细胞淋巴细胞比值 改良格拉斯哥预后评分 预后 |
| 英文关键词: Advanced gastric cancer Radical gastrectomy Monocyte-lymphocyte ratio Modified Glasgow prognostic score Prognosis |
| 基金项目:福建省南平市科技计划项目（N2014D021） |
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| 中文摘要: |
| 摘要 目的：探讨单核细胞和淋巴细胞比值（monocyte-lymphocyte ratio, MLR）、改良格拉斯哥预后（modified Glasgow prognostic score, mGPS）评分与进展期胃癌患者胃癌根治术后预后的关系。方法：回顾性分析2018年4月至2021年4月在我院接受胃癌根治术的106例进展期胃癌患者资料，术后随访3年。比较不同临床特征患者的MLR、mGPS评分。采用Kaplan-Meier法分析不同MLR、mGPS分组患者的生存差异，并绘制生存曲线。运用Cox回归模型对临床特征、实验室指标MLR、mGPS评分等变量进行分析，筛选出影响患者预后的独立因素。构建受试者工作特征（receiver operating characteristic, ROC）曲线，评估MLR、mGPS评分及二者联合预测患者不良预后的效能，并计算曲线下面积（area under curve, AUC）、敏感度及特异度。结果：MLR、mGPS评分与肿瘤TNM分期、分化程度、肿瘤直径、淋巴结转移及术后化疗相关（P<0.05）。MLR≥0.3组和mGPS≥1组3年生存率分别为45.20%和50.00%，远低于MLR和mGPS低分组（78.40%和82.40%，P<0.05）。高风险组（MLR≥0.3且mGPS≥1）生存率29.41%，显著低于中、低风险组（P<0.05）。Cox多因素分析显示，临床分期高、有淋巴结转移、分化程度高、高MLR和高mGPS评分是影响患者预后的独立危险因素。ROC曲线显示，MLR、mGPS评分单独预测患者不良预后的AUC为0.756、0.842，两者联合检测的AUC为0.909，两者联合检测预测效能显著优于单项检测。结论：MLR和mGPS评分升高可作为进展期胃癌术后独立预后指标，两者联合检测有助于为临床预后评估提供更准确的判断依据。 |
| 英文摘要: |
| ABSTRACT Objective: To explore the relationship between monocyte-lymphocyte ratio (MLR), modified Glasgow prognostic score (mGPS) and the prognosis of patients with advanced gastric cancer after radical gastrectomy. Methods: A retrospective analysis was conducted on the data of 106 patients with advanced gastric cancer who underwent radical gastrectomy in our hospital from April 2018 to April 2021, the patients were followed up for 3 years after the operation. MLR and mGPS scores of patients with different clinical characteristics were compared. The Kaplan-Meier method was used to analyze the survival differences of patients in different MLR and mGPS groups, and the survival curves were plotted. The Cox regression model was used to analyze variables such as clinical characteristics, laboratory indicators, MLR and mGPS scores, and to screen out the independent factors affecting the prognosis of patients. The receiver operating characteristic (ROC) curve was constructed to evaluate the efficacy of MLR, mGPS scores and their combination in predicting poor prognosis efficiency of patients, and the area under the curve (AUC), sensitivity and specificity were calculated. Results: MLR and mGPS scores were correlated with tumor TNM stage, degree of differentiation, tumor diameter, lymph node metastasis and postoperative chemotherapy (P<0.05). The 3-year survival rates of the MLR≥0.3 group and mGPS≥1 group were 45.20% and 50.00% respectively, which were much lower than those in the low MLR group and mGPS group (78.40% and 82.40%, P<0.05). The survival rate in the high-risk group (MLR≥0.3 and mGPS≥1) was 29.41%, significantly lower than those in the medium and low-risk groups (P<0.05). Cox multivariate analysis showed that high clinical stage, lymph node metastasis, high degree of differentiation, high MLR and high mGPS scores were independent risk factors affecting the prognosis of patients. ROC curve showed that the AUC of MLR and mGPS scores alone in predicting poor prognosis of patients was 0.756 and 0.842, respectively, the AUC of combination detection the two was 0.909, the predictive efficacy of the combination detection was significantly better than that of the single detection. Conclusion: Elevated MLR and mGPS scores can be used as independent prognostic indicators after advanced gastric cancer, the combination in predicting is helpful to provide a more accurate basis for clinical prognosis assessment. |
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