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| 炎症指标与黑色素瘤三级淋巴结构状态的相关性研究 |
| Correlation of Inflammatory Markers and the Status of Tertiary Lymphoid Structures in Melanoma |
| 投稿时间：2024-07-25 修订日期：2024-09-18 |
| DOI： |
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| 中文关键词: 三级淋巴结构 恶性黑色素瘤 炎症指标 肿瘤微环境 |
| 英文关键词:Tertiary lymphoid structures Malignant melanoma Inflammatory markers Tumor microenvironment. |
| 基金项目:国家自然科学基金项目（面上项目，重点项目，重大项目） |
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| 摘要点击次数: 112 |
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| 中文摘要: |
| 目的 本研究旨在探究外周血C反应蛋白(C-reactive protein, CRP)、乳酸脱氢酶(lactate dehydrogenase，LDH)、中性粒细胞与淋巴细胞比值(neutrophil lymphocyte ratio，NLR)及全身炎症反应指数(systemic inflammation response index, SIRI)等炎症指标与恶性黑色素瘤患者肿瘤内三级淋巴结构(tertiary lymphoid structures, TLS)状态的相关性。
方法 共纳入2013年2月至2021年12月间于南京鼓楼医院首诊且行手术切除的64例黑色素瘤患者。收集患者术前血常规、血生化检查结果，提取其中淋巴细胞计数、中性粒细胞计数、单核细胞计数、C反应蛋白和乳酸脱氢酶结果。根据患者术后病理切片行HE染色评估患者TLS状态，根据肿瘤组织中是否存在TLS将患者分组，肿瘤内存在TLS组患者，根据肿瘤病灶中心是否存在TLS进一步分组。应用受试者工作特征(receiver operating characteristic, ROC)曲线确定相关指标预测TLS 状态的最佳截断值，采用单因素及多因素logistics回归分析评估TLS状态的独立预测因素。
结果 单因素logistics回归分析显示，CRP、LDH、NLR和SIRI水平与患者肿瘤内存在TLS有关(P＜0.1)，年龄、CRP和LDH水平与患者肿瘤中心存在TLS有关(P＜0.1)。多因素logistics回归分析显示，LDH≤205.5 U/L(OR=0.168，P=0.022)、全身炎症反应指数(systemic inflammatory response index, SIRI)≤0.95(OR=0.235，P=0.039) 可作为肿瘤内存在TLS的独立预测因素。在肿瘤内存在TLS组患者中，C反应蛋白(C-reactive protein，CRP)≤2.7 mg/L(OR=0.208、P=0.021)、LDH＞177.5 U/L(OR=4.557，P=0.034)可作为肿瘤中心存在TLS的独立预测因素。 |
| 英文摘要: |
| Objective To explore the correlation between peripheral blood inflammatory markers, specifically C-reactive protein(CRP), Lactate dehydrogenase(LDH), Neutrophil lymphocyte ratio(NLR), and systemic inflammation response index(SIRI) and the status of Tertiary lymphoid structures(TLS) in patients with malignant melanoma.
Methods
A total of 64 patients diagnosed with malignant melanoma for the first time and underwent surgical resection at Nanjing Drum Tower Hospital, from February 2013 to December 2021. Preoperative blood routine test and biochemical examination were collected, including lymphocyte count, neutrophil count, monocyte count, CRP, and LDH.TLS status in tumors was analyzed using HE staining. Patients were divided into groups based on the presence of TLS in the tumor tissue and further categorized according to the presence of TLS in the center of the tumor. Receiver operating characteristic (ROC) curves were used to determine the optimal cutoff values for predicting TLS status. Univariate and multivariate logistic regression analyses were conducted to identify independent predictors of TLS presence.
Results Univariate logistic regression analysis showed that CRP, LDH, NLR, and SIRI levels were associated with the presence of TLS in the tumor (P < 0.1). Additionally, age, CRP, and LDH levels were linked to the presence of Intratumoral TLS (P < 0.1). Multivariate logistic regression analysis revealed that LDH ≤ 205.5 U/L (OR = 0.168, P = 0.022) and SIRI ≤ 0.95 (OR = 0.235, P = 0.039) were independent predictors for the presence of TLS in the tumor. Among patients with TLS in the tumor, CRP ≤ 2.7 mg/L (OR = 0.208, P = 0.021) and LDH > 177.5 U/L (OR = 4.557, P = 0.034) were identified as independent predictors for the presence of Intratumoral TLS. |
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