摘要
目的 探讨辅助放射治疗前的中性粒细胞/淋巴细胞计数值(NLR),血小板/淋巴细胞计数值(PLR)在宫颈癌根治术后患者预后评估中的价值.方法 回顾性分析2010-07-01-2018-07-31在四川大学华西医院接受术后辅助放疗的264例宫颈癌患者临床及病理资料.通过受试者工作特征(ROC)曲线确定NLR及PLR的最佳临界值(cut-off值),依据临界值将患者分为低NLR组(NLR<3.69,n=222)和高NLR组(NLR≥3.69,n=42);低PLR组(PLR<169.60,n=155)和高PLR组(PLR≥169.60,n=109);低NLR+低PLR组(NLR<3.69且PLR<169.60,n=141)、低NLR+高PLR组(NLR<3.69且PLR≥169.60,n=77)、高NLR+高PLR组(NLR≥3.69且PLR≥169.60,n=26)和高NLR+低PLR组(NLR≥3.69且PLR<169.60,n=12).分析基线NLR、PLR水平以及临床特征与生存预后的关系.采用Kaplan-Meier生存分析比较各组患者生存差异.结果 不同NLR水平患者总生存期(OS,χ^(2)=6.186,P=0.013)和无进展生存期(PFS,χ^(2)=5.902,P=0.015)差异有统计学意义.不同PLR水平患者OS(χ^(2)=4.261,P=0.039)差异有统计学意义.高NLR+高PLR组患者较其余组患者OS(χ^(2)=12.581,P=0.006)和PFS(χ^(2)=9.121,P=0.028)均下降,差异有统计意义.多因素分析结果显示,高NLR+高PLR是PFS(HR=3.248,95%CI:1.032~10.223,P=0.044)和OS(HR=10.188,95%CI:1.588~65.369,P=0.014)的独立危险因素.结论 NLR和PLR与宫颈癌患者术后辅助放射治疗后的PFS及OS相关.NLR联合PLR值具有更好的预后预测价值;高NLR+高PLR患者具有更差的PFS和OS.基线NLR和PLR检测在宫颈癌患者术后辅助放疗预后评估中有一定的临床价值.
Objective To investigate the value of neutrophil to lymphocyte ratio(NLR) and platelet to lymphocyte ratio(PLR) before adjuvant radiotherapy in the prognosis evaluation of patients after radical resection of cervical cancer.Methods The clinical and pathological data of 264 patients with cervical cancer who received postoperative adjuvant radiotherapy in West China Hospital of Sichuan University from 2010-07-01-2018-07-31 were analyzed retrospectively.The optimal cut-off value of NLR and PLR was determined by receiver operating characteristic(ROC) curve, and patients were divided into low NLR group(NLR<3.69,n=222) and high NLR group(NLR≥3.69,n=42),low PLR group(PLR<169.60,n=155) and high PLR group(PLR≥169.60,n=109),low NLR+low PLR group(NLR<3.69 and PLR<169.60,n=141),low NLR+high PLR group(NLR<3.69 and PLR≥169.60,n=77),high NLR+high PLR group (NLR≥3.69and PLR≥169.60,n=26)and high NLR+low PLR group(NLR≥3.69and PLR<169.60,n=12).The relationship between baseline NLR and PLR levels and clinical characteristics and survival prognosis was analyzed.KaplanMeier survival analysis was used to compare the survival differences between the groups.Results There were significant differences in overall survival(OS,χ^(2)=6.186,P=0.013)and progression-free survival(PFS,χ^(2)=5.902,P=0.015)among patients with different NLR levels.There was a statistically significant difference in OS(χ^(2)=4.261,P=0.039)between patients with different PLR levels.The OS(χ^(2)=12.581,P=0.006)and PFS (χ^(2)=9.121,P=0.028)of the patients in the high NLR+high PLR group were lower than those in the other groups,and the difference was statistically significant.Multivariate analysis showed that high NLR+high PLR was independent risk factors of PFS(HR=3.248,95%CI:1.032-10.223,P=0.044)and OS(HR=10.188,95%CI:1.588-65.369,P=0.014).Conclusions NLR and PLR are associated with PFS and OS after postoperative adjuvant radiation therapy in cervical cancer patients.NLR combined with PLR value has better prognostic value.The high NLR+high PLR patients have worse PFS and OS.Baseline NLR and PLR detection have certain clinical value in the prognosis evaluation of postoperative adjuvant radiotherapy in patients with cervical cancer.
作者
盛雷鸣
欧阳淦露
舒佩
沈亚丽
王辛
SHENG Lei-ming;OUYANG Gan-lu;SHU Pei;SHEN Ya-li;WANG Xin(Cancer Center,West China Clinical Medical College,Sichuan University,Chengdu 610041,China;Department of Oncology,West China Fourth Hospital,Sichuan University,Chengdu 610041,China;Department of Abdominal Oncology,Cancer Center,West China Hospital,Sichuan University,Chengdu 610041,China)
出处
《中华肿瘤防治杂志》
CAS
北大核心
2022年第8期584-591,共8页
Chinese Journal of Cancer Prevention and Treatment
基金
成都市科技项目重点研发支撑计划(2019-YF05-00771-SN)
2020四川大学临床医学院/华西医院住院医师/专科医师科研基金(20200224195822)。
作者简介
第一作者:盛雷鸣,男,四川达州人,主治医师,主要从事结直肠癌、宫颈癌综合治疗的研究工作。E-mail:454662260@qq.com;通信作者:王辛,女,四川成都人,博士,主任医师,主要从事结直肠癌、胃癌、肝癌和宫颈癌综合治疗的研究工作。E-mail:wangxin213@sina.com。
