[1]王承霞a,侯 宁b,杨翊柠a,等.术前纤维蛋白原与淋巴细胞比值在胃癌神经侵犯预测价值研究[J].现代检验医学杂志,2023,38(02):160-165.[doi:10.3969/j.issn.1671-7414.2023.02.030 ]
　WANG Cheng-xiaa,HOU Ningb,YANG Yi-ninga,et al.Predictive Value of Preoperative fibrinogen-to-Lymphocyte Ratio in Gastric Cancer with Perineural Invasion[J].Journal of Modern Laboratory Medicine,2023,38(02):160-165.[doi:10.3969/j.issn.1671-7414.2023.02.030 ]
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术前纤维蛋白原与淋巴细胞比值在胃癌神经侵犯预测价值研究()
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《现代检验医学杂志》[ISSN:/CN:]

卷:
第38卷
期数:
2023年02期
页码:
160-165
栏目:
检验与临床
出版日期:
2023-03-15

文章信息/Info

Title:
Predictive Value of Preoperative fibrinogen-to-Lymphocyte Ratio in Gastric Cancer with Perineural Invasion
文章编号:
1671-7414（2023）02-160-06
作者:
王承霞a; 侯 宁b; 杨翊柠a; 莫冬萍a
（江苏省肿瘤医院 /南京医科大学附属肿瘤医院 /江苏省肿瘤防治研究所 a.检验科；b.病理科，南京 210009）
Author(s):
WANG Cheng-xiaa;  HOU Ningb;  YANG Yi-ninga;  MO Dong-pinga
（a. Department of Clinical Laboratory；b. Department of Pathology, Jiangsu Cancer Hospital & the Affiliated Cancer Hospital of Nanjing Medical University & Jiangsu Institute of Cancer Research, Nanjing 210009，China）
关键词:
胃癌; 神经侵犯; 纤维蛋白原与淋巴细胞比值; 淋巴结转移
分类号:
R735.2；R730.43
DOI:
10.3969/j.issn.1671-7414.2023.02.030
文献标志码:
A
摘要:
目的 探索术前纤维蛋白原与淋巴细胞比值 (fibrinogen lymphocyte ratio, flR)在胃癌神经侵犯 (perineural invasion，PNI)中的临床意义。方法 收集 2020年 10月～2022年 2月在江苏省肿瘤医院接受手术切除且经病理学检查证实为胃癌并符合入组的患者 360例，同时收集临床病理资料。受试者工作曲线（ROC）确定术前 flR判断胃癌神经侵犯发生的最佳截断值。采用二分类 Logistic回归进行单因素和多因素分析，确定与神经侵犯发生相关的危险因素。结果 神经侵犯阳性患者的 flR水平 (2.37 ±1.31)明显高于神经侵犯阴性组的 flR水平 (1.87 ±0.90)，差异有统计学意义 (t=4.184, P<0.05)；同时神经侵犯阳性组患者的恶性程度（肿瘤浸润程度，淋巴结转移，TNM分期）更显著，差异有统计学意义 (t=162.110，70.530，142.910，均 P<0.05)。ROC曲线分析，flR曲线下面积为 0.650(95% CI：0.592～0.707)，最佳截断值为 1.82，灵敏度和特异度分别为 64.4%，62.4%。Logistic多因素分析显示 flR>1.82 (OR=2.155, 95% CI： 1.086～4.277, P=0.028)，肿瘤浸润程度 (OR=6.405，95% CI：2.040～20.107，P=0.001)，II期 (OR=7.002，95% CI： 1.614～30.374，P=0.009)和 III期 (OR=10.718，95% CI：1.809～63.498，P=0.009)是胃癌患者发生神经侵犯的独立危险因素。在淋巴结发生转移组中，多因素分析显示， flR>1.82(OR=2.311, 95% CI：1.074～4.974，P=0.032)和肿瘤浸润程度 (OR=12.401，95% CI：4.549～33.806，P<0.001)是患者发生神经侵犯的独立危险因素。结论 术前监测 flR水平对预测胃癌患者发生神经侵犯有一定参考价值。
Abstract:
Objective To determine the clinical significance of fibrinogen lymphocyte ratio (flR) in gastric cancer (GC) patients with or without perineural invasion (PNI). Methods A total of 360 patients who underwent surgical resection in Jiangsu Cancer Hospital from October 2020 to February 2022 and were confirmed to be GC by pathological examination and were eligible for inclusion were collected. The receiver operating curve (ROC) was used to determine the optimal cut-off value of preoperative flR for judging PNI in GC. Univariate and multivariate logistic regression analyses were used to calculate the independent predictors. Results Compared with the PNI(-) group（1.87±0.90）, the PNI(+) patients had significantly higher levels of flR (2.37 ±1.31）, and the difference was statistically significant（t=4.184，P<0.05). A higher degree of malignancy(degree of tumor invasion, lymph node metastasis and TNM stage), and the differences were statistically significant(t=162.110, 70.530, 142.910, all P<0.05). The area under the ROC curve of flR diagnosis for PNI(+) was 0.650 (95% CI：0.592～0.707), the best cut-off value was 1.82, the sensitivity and specificity was 64.4%, 62.4%. Logistic multivariate analysis showed that flR>1.82 (OR=2.155, 95% CI:1.086～4.277, P=0.028), degree of tumor invasion (OR=6.405, 95% CI:2.040～20.107, P=0.001), stage II (OR=7.002, 95% CI:1.614～30.374, P=0.009) and stage III (OR=10.718,95% CI: 1.809～63.498, P=0.009) were an independent risk factor for PNI(+) in patients with GC. In the lymph node metastasis group, multivariate analysis showed that flR>1.82 (OR=2.311, 95% CI:1.074～4.974, P =0.032) and degree of tumor invasion (OR=12.401,95% CI: 4.549～33.806, P<0.001) were an independent risk factors for PNI(+) in patients with lymph node metastasis. Conclusion Preoperative monitoring of flR levels has a certain reference value for predicting the occurrence of PNI(+) in patients with GC.

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备注/Memo

备注/Memo:
收稿日期：2022-07-12修回日期：2022-08-02
基金项目：国家自然科学基金（82002225）：trf-17-79MP99PP作为乳腺癌新型诊断标志物的价值及其作用机制研究。
作者简介：王承霞 (1973-)，女，本科，主管技师，研究方向：临床检验，E-mail: newwcx@163.com。
通讯作者：莫冬萍 (1986-)，女，硕士，主管技师，研究方向：临床检验诊断学，E-mail:modongping1223@163.com。

更新日期/Last Update: 2023-03-15