| Objective To investigate the four ratios of NLR ? PLR ? LMR and MWR in preoperative peripheral blood and evaluate the prognostic value of gastrointestinal stromal tumor(GIST)in reducing postoperative recurrence.Methods The clinical data of 60 GIST patients admitted in general surgery from January2017 to January 2019 were retrospectively analyzed.The absolute values of neutrophils,lymphocytes,monocytes,platelets and lymphocytes(NLR),platelets to lymphocytes(PLR),lymphocytes to monocytes(LMR)and monocytes to leukocytes(MWR)were calculated.According to the subject work characteristic curve(ROC curve),the respective boundary values were calculated,and the patients were divided into high value group and low value group respectively.Follow up for two years to understand the prognosis of patients in each group.the COX regression model was used to analyze the factors affecting the prognosis of patients with knot GIST,and a risk scoring system was established to evaluate the prognosis of patients.the postoperative survival time without recurrence(RFS)was analyzed by Kaplan-Meier.Results The boundary values of NLR?PLR?LMR and MWR were 2.43,144.04,4.47 and 3.82,respectively.The patients were divided into high NLR group,high PLR group,high LMR group,high MWR group,low PLR group,low LMR group and low MWR group.compared with low NLR group,low PLR group and low MWR group,Patients in high NLR,high PLR and MWR groups had shorter survival time(P<0.05).The postoperative RFS was shorter in the low-high LMR group(P<0.05).The results of univariate analysis showed that tumor size,number of mitotic images,location,lymph node metastasis,and the adverse factors affecting the RFS of GIST patients with high NLR? high MWR and low LMR before operation(P<0.05);COX multivariate analysis revealed staging: tumor size(RR=1.122,95%CI : 1.977~3.034,P=0.001);Number of mitotic elephants(RR=1.122,95%CI : 1.977~3.034,P=0.001)? Number of mitotic elephants(RR=3.979,95%CI : 1.044~5.568,P=0.002).Number of mitotic images(RR=3.979,95% CI:1.044RR=5.568,PCI:1.044RR=0.002),site(RR=3.313,95% CI:1.241~4.419,PRR=0.001),high NLR(RR=1.879,95%,6.145,PRR=0.016),High PLR levels(RR=1.444,95 CI : 1.435RR=9.517,PCI : 1.435RR=0.049),high MWR levels(RR=6.345,95%CI:1.122~9.134,P=0.036),high MWR levels(RR=6.345,95% CI:1.122~9.134,PRR=0.036)and low LMR levels(RR=2.432,95% CI : 0.313~6.127,PRR=0.033)were independent prognostic factors affecting postoperative RFS in patients(all P were 0.05).Conclusions Preoperative NLR ? PLR ? MWR and LMR are the independent prognostic factors of survival time without recurrence after operation in patients with knot GIST.It is concluded that the four ratio of preoperative NLR?PLR?MWR and LMR can provide the basis for the treatment of clinical guidance knot GIST,and can be combined with the four ratio before operation to predict the possibility of recurrence and metastasis.Figure 9;Table5;Reference 151... |
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