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Received:November 16, 2023 Published Online:February 20, 2024
Received:November 16, 2023 Published Online:February 20, 2024
中文摘要: 目的 探索循环肿瘤细胞（circulating tumor cell, CTC）联合中性粒细胞/淋巴细胞比值（neutrophil to lymphocyte ratio, NLR）对晚期胃癌疗效的预测作用。方法 收集2022年6月至2023年1月在南京医科大学附属江宁医院及江苏省肿瘤医院接受一线治疗的36例晚期胃癌患者的临床病理资料。通过X tile软件计算CTC和NLR的最佳截断值，将患者分为高CTC组（CTC>15，n=21）和低CTC组（CTC≤15，n=15），高NLR组（NLR>2.32，n=20）和低NLR组（NLR≤2.32，n=16）。COX回归分析和生存曲线用于分析CTC，NLR与无进展生存期（progression free survival, PFS）的关系。受试者工作特征（ROC）曲线比较CTC、NLR和两者联合对晚期胃癌疗效的预测效能。结果 多因素COX回归分析显示，CTC（HR=7.441, P=0.045）和NLR（HR=4.690, P=0.011）与晚期胃癌患者的PFS有关。低CTC组和低NLR组患者的PFS分别长于高CTC组和高NLR组(P<0.01)。同时具有高CTC和高NLR的患者PFS最短(P<0.01)。与CTC和NLR单一因素预测相比，两者联合预测晚期胃癌一线治疗疗效最佳(AUC=0.746)。结论 CTC和NLR是影响晚期胃癌患者PFS的独立预后因子，CTC联合NLR能更好地预测晚期胃癌疗效。
中文关键词: 循环肿瘤细胞 中性粒细胞/淋巴细胞比值 胃癌晚期 一线治疗 无进展生存期
Abstract:Objective To investigate the predictive effect of circulating tumor cell (CTC) combined with neutrophil to lymphocyte ratio (NLR) on efficacy of advanced gastric cancer. Methods The clinicopathological data of 36 patients with advanced gastric cancer who received first line treatment in Jiangning Hospital Affiliated to Nanjing Medical University and Jiangsu Cancer Hospital from June 2022 to January 2023 were collected. The optimal cutoff values of CTC and NLR were calculated using X tile software, and the patients were divided into high CTC group (CTC>15, n=21) and low CTC group (CTC≤15, n=15), high NLR group (NLR>2.32, n=20) and low NLR group (NLR≤2.32, n=16). COX regression analysis and survival curve were used to analyze the relationship between CTC, NLR and progression free survival (PFS). Receiver operating characteristic (ROC) curves compared the predictive power of CTC, NLR, and the combination in predicting the outcome of advanced gastric cancer. Results Multivariate COX regression analysis showed that CTC (HR=7.441, P=0.045) and NLR (HR=4.690, P=0.011) were associated with PFS in patients with advanced gastric cancer. Patients in CTC group and low NLR group had longer PFS than those in high CTC group and high NLR group, respectively (P<0.01). Patients with both high CTC and high NLR had the shortest PFS (P<0.01). Compared with the single factor prediction, the combination of CTC and NLR predicted the efficacy of first line treatment for advanced gastric cancer best (AUC=0.746). Conclusion CTC and NLR are independent prognostic factors affecting PFS in patients with advanced gastric cancer, and CTC combined with NLR can better predict the efficacy of advanced gastric cancer.
keywords: Circulating tumor cells Neutrophil/lymphocyte ratio Gastric cancer, advanced First line treatment rogression free survival
文章编号： 中图分类号：R735.2 文献标志码：A
基金项目:江苏省研究生科研创新项目(SJCX22_〖KG-*2〗0657)；江苏省自然科学基金（BK20161110）
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