陈丽鹃,刘俊远,俞婷婷,等.NLR、dNLR、PLR对195例广泛期小细胞肺癌预后评估价值分析[J].肿瘤学杂志,2023,29(12):1011-1016.
NLR、dNLR、PLR对195例广泛期小细胞肺癌预后评估价值分析
Prognostic Value of NLR, dNLR and PLR for 195 Cases with Extensive-Stage Small Cell Lung Cancer
投稿时间:2023-01-30  
DOI:10.11735/j.issn.1671-170X.2023.12.B004
中文关键词:  广泛期小细胞肺癌  中性粒细胞/淋巴细胞比值  衍生中性粒细胞/淋巴细胞比值  血小板/淋巴细胞比值
英文关键词:extensive-stage small cell lung cancer  neutrophil-to-lymphocyte ratio  platelet-to-lymphocyte ratio  derived neutrophil-to-lymphocyte ratio
基金项目:省部共建中亚高发病成因与防治国家重点实验室开放课题(SKL-HIDCA-2020-JZ)
作者单位
陈丽鹃 新疆医科大学附属肿瘤医院 
刘俊远 新疆医科大学附属肿瘤医院 
俞婷婷 新疆医科大学附属肿瘤医院 省部共建中亚高发病成因与防治国家重点实验室 
韩志刚 新疆医科大学附属肿瘤医院 
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中文摘要:
      摘 要:[目的] 探讨广泛期小细胞肺癌(small cell lung cancer)患者中性粒细胞/淋巴细胞比值(neutrophil-to-lymphocyte ratio,NLR)、血小板/淋巴细胞比值(platelet-to-lymphocyte ratio,PLR)、衍生中性粒细胞/淋巴细胞比值(derive neutrophil-to-lymphocyte ratio,dNLR)对预后的评估价值。[方法] 选取195例广泛期SCLC患者,收集患者血常规数据,分析临床特征、NLR、dNLR、PLR对预后的影响。根据ROC曲线得到NLR、dNLR、PLR的最佳临界值,分析NLR、dNLR、PLR对广泛期SCLC患者PFS和OS的影响。[结果] ROC曲线得到NLR、dNLR、PLR最佳临界值分别为2.4、2.2和170。单因素分析显示EP/C方案化疗>4个周期、放疗、NLR≤2.4、dNLR≤2.2、PLR≤170与较长中位无进展生存期(progression-free survival,PFS)相关(P<0.05),年龄≤60岁、女性、EP/C方案化疗>4个周期、放疗、NLR≤2.4、dNLR≤2.2、PLR≤170与较长总生存期(overall survival,OS)相关。Cox回归分析显示放疗(HR=0.29,95%CI:0.20~0.42,P<0.01)、EP/C方案化疗>4个周期(HR=0.56,95%CI:0.39~0.79,P<0.01)有利于PFS延长,NLR>2.4(HR=1.64,95%CI:1.08~2.50,P=0.02)为PFS的危险因素;放疗(HR=0.24,95%CI:0.17~0.36,P<0.01)、EP/C方案化疗>4个周期(HR=0.64,95%CI:0.45~0.91,P=0.01)有利于OS延长,年龄>60岁(HR=1.66,95%CI:1.16~2.36,P<0.01)、NLR>2.4(HR=2.60,95%CI:1.65~4.09,P<0.01)、dNLR>2.2(HR=1.651,95%CI:1.11~2.47,P=0.01)为OS的危险因素。[结论] NLR、dNLR、PLR与广泛期SCLC患者预后相关,高NLR患者PFS较短,高NLR、高dNLR患者OS较短。
英文摘要:
      Abstract:[Objective] To investigate the prognostic value of neutrophil-to-lymphocyte ratio(NLR), platelet-to-lymphocyte ratio(PLR), derived neutrophil-to-lymphocyte ratio(dNLR) for patients with extensive-stage small cell lung cancer(SCLC). [Methods] One hundred and ninety-five patients with extensive-stage SCLC were enrolled in the study. The association of NLR, dNLR and PLR with progression-free survival(PFS) and overall survival(OS) in patients with extensive-stage SCLC were analyzed by multivariate Cox regression model, and their prognostic value was evaluated by ROC curve. [Results] According to the ROC curve, the optimal cut-off values of NLR, dNLR and PLR were 2.4, 2.2 and 170, respectively. Univariate analysis showed that EP/C regimen chemotherapy >4 cycles, radiotherapy, NLR≤2.4, dNLR≤2.2, PLR≤170 were associated with longer PFS(P<0.05), and age≤60 years old, female, EP/C regimen chemotherapy >4 cycles, radiotherapy, NLR≤2.4, dNLR≤2.2, PLR≤170 were associated with longer OS(P<0.05). Cox regression analysis showed that radiotherapy(HR=0.29, 95%CI: 0.20~0.42, P<0.01) and EP/C regimen chemotherapy>4 cycles(HR=0.56, 95%CI: 0.39~0.79, P<0.01) were beneficial for prolonged PFS; while NLR>2.4(HR=1.64, 95%CI: 1.08~2.50, P=0.02) were risk factors for shortened PFS. Radiotherapy(HR=0.24, 95%CI: 0.17~0.36, P<0.01) and EP/C regimen chemotherapy > 4 cycles(HR=0.64, 95%CI: 0.45~0.91, P=0.01) were beneficial for prolonged OS; while age>60 years old(HR=1.66, 95%CI: 1.16~2.36, P<0.01), NLR>2.4(HR=2.60, 95%CI: 1.65~4.09, P<0.01) and dNLR>2.2(HR=1.651, 95%CI: 1.11~2.47, P=0.01) were risk factors for shortened OS. [Conclusion] NLR, dNLR, PLR are associated with the prognosis of patients with extensive SCLC. Patients with high NLR are likely to have shorter PFS, while patients with high NLR and high dNLR are more likely to have shorter OS.
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