| Objective To explore the preoperative peripheral blood monocyte-to-lymphocyte ratio(MLR),monocyte-to-white blood cell ratio(MWR)and medium of gastrointestinal stromal tumors.The clinical significance of neutrophil-to-white blood cell ratio(NWR)in the early prediction of risk classification.Methods A total of 136 patients with gastrointestinal stromal tumors who were admitted to our hospital from January 1,2005 to September 30,2020 and were diagnosed as gastrointestinal stromal tumors by pathological diagnosis were collected retrospectively.According to the “Chinese Society of Clinical Oncology(CSCO)Guidelines for the Diagnosis and Treatment of Gastrointestinal Stromal Tumor 2020” issued by the National Institute of Health(NIH),all GIST patients were divided into a low-risk group of 42cases(because of extremely low risk).The number of risk patients is very small,so the two groups were combined),31 cases in the medium risk group,and 63 cases in the high risk group.At the same time,60 healthy adult health examiners with matching basic information were selected as the control group.Relevant clinicopathological data such as gender,age,ethnicity,primary tumor location,tumor size,mitotic image count,and preoperative blood routine test values were recorded respectively in GIST patients.Draw receiver operating characteristic(ROC)curves of different risk grades,calculate the optimal cut-off values of MLR,MWR and NWR,area under the ROC curve(AUC),sensitivity and specificity under different risk grades before surgery Analyze the feasibility of preoperative three kinds of inflammation indexes in early prediction of different risk grades of GIST.Results1.GIST comparisons with different risk groups and health control groups,there is no significant difference in age,gender,and national factors(all P>0.05).2.Comparison of different dangerous groups and health control groups:China-risk group,high-risk MLR levels above the control group,have statistically significant(all P<0.01);medium-sanitation,high-risk MWR levels higher than the control group,have statistics Significance(all P<0.01);low-risk,medium-sangered groups and high-risk group NWR levels are higher than the control group,which have statistical significance(P<0.01).3.Comparison between groups with different risk grades: MLR level in low-risk group was significantly higher than that in high-risk group,with statistical significance(P<0.01);The level of MWR in low-risk group was significantly higher than that in high-risk group,with statistical significance(P<0.01).The NWR level of low-risk group,medium-risk group and high-risk group was pairwise compared,and the medium-risk group and high-risk group were higher than the low-risk group,with statistical significance(all P<0.01).4.Low-risk group: The AUC of NWR was 0.739(95%CI0.634-0.844,sensitivity 53.3%,specificity 83.3%,P<0.0001),which had certain preoperative predictive value for very low-risk and low-risk GIST patients.5.Intermediate risk group: The AUC of NWR is 0.825(95%CI0.735-0.915,sensitivity 71.0%,specificity 85.0%,P<0.0001),which is better than MLR and MWR in terms of AUC,sensitivity and specificity,so NWR Higher preoperative predictive value for patients with intermediate-risk GIST.6.High-risk group: The AUC of NWR is 0.908(95%CI 0.858-0.959,sensitivity 82.5%,specificity 83.3%,P<0.0001),which is better than MLR and MWR in terms of AUC,sensitivity and specificity,so NWR is high Preoperative predictive value of risky GIST patients is higher.Conclusion Preoperative MLR,MWR and NWR are related factors to predict the risk grading of GIST,and can be used for the assessment of the risk grading of GIST in the early stage of clinical prediction,among which NWR has obvious advantages in predicting ability and accuracy. |
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