关键词: 胃肠道间质瘤, 中性粒细胞/淋巴细胞比例, 纤维蛋白原含量, 预后

Abstract: Objective:To evaluate the effects of  biomarkers，including  neutrophiltolymphocyte ratio（NLR） and fibrinogen content（FIB） to local recurrence  and/ or distant metastasis  and  5year  recurrence  free  survival （RFS） in  patients  with  gastrointestinal stromal tumor（GIST） after  radical  surgery.Methods:170 patients with GIST who was from January of 2010 to December of 2015 in the First Affiliated Hospital of Xi 'an Jiaotong University after radical surgery without neoadjuvant therapy（imatinib）were retrospectively analyzed.The biomarkers included NLR and FIB.SPSS 18 was used for ROC analysis，chi square test，and MannWhitney U test，correlation analysis was performed with the Pearson correlation test.The longterm survival was analyzed by KaplanMeier survival analysis.Multivariate factors for survival were analyzed by Cox proportional hazards regression model.Results:170 patients were included in this study.During followup，24 patients showed recurrence or metastasis，15 patients suffered from GIST related deaths，1 patient was due to the death of car accidents.Establishment of Roc Curve for diagnosis of GIST，the area under the ROC curve of NLR and FIB was 0.608，0.758，respectively.When NLR=1.864，FIB=3.24g /L was taken as the dividing point respectively，NLR and FIB had the highest sensitivity and specificity in the diagnosis of GIST.There was a correlation between NLR，FIB and age，sex，tumor location，size and risk grade of GIST patients，and there was also a correlation between NLR and FIB.The RFS of 5 years after the operation was 75% in the present study.5 years RFS rate of NLR<1.864 group and greater in the NLR group were 90% and 62%，respectively（P=0.018），FIB＜3.24 g/L and greater in the FIB group were 95% and 50%，respectively（P＜0.01）； FIB and NLR were jointed and divided into 4 groupsGroup 1：FIB＜3.24g/L and NLR＜1.864，Group 2：FIB≥3.24g/L and NLR〖LM〗 ＜1.864，Group 3：FIB≥3.24g/L and NLR≥1.864，Group 4：FIB＜3.24g/L and NLR≥1.864，and 5 year RFS rate of 4 group were 100%，78%，38% and 92%，respectively（P＜0.01）.Multivariate analysis showed that FIB（P＜0.01，HR=0.108，95%CI：0.0290.333）and NIH risk classification（P=0.001，HR=0.128，95%CI：0.0370.443）was an independent risk factor affecting the prognosis of GIST.Conclusion:The combination of NLR and FIB can effectively predict the postoperative prognosis of GIST patients，but this conclusion needs further study and confirmation.

Key words: gastrointestinal stromal tumor, neutrophil to lymphocyte ratio, fibrinogen, prognosis