中性粒细胞与淋巴细胞比值对宫颈癌患者同步放化疗疗效及预后判断的临床意义

doi:10.11904/j.issn.1002-3070.2018.05.004

实用肿瘤学杂志 ›› 2018, Vol. 32 ›› Issue (5): 404-409.doi: 10.11904/j.issn.1002-3070.2018.05.004

中性粒细胞与淋巴细胞比值对宫颈癌患者同步放化疗疗效及预后判断的临床意义

王一然^1,2, 黄维³, 尹蕾^1,2, 刘琳⁴, 周晓平⁵, 牛星鉴⁵, 杨悦^1,2, 安巍巍^1,2, 姬宏飞^1,2

1.哈尔滨医科大学肿瘤防治研究所(哈尔滨 150081);
2.黑龙江省医学科学院;
3.哈尔滨医科大学附属肿瘤医院肿瘤妇科;
4.哈尔滨医科大学医学影像学系;
5.哈尔滨医科大学附属肿瘤医院肿瘤内科

收稿日期:2018-04-02 出版日期:2018-10-28 发布日期:2018-10-23
通讯作者: 姬宏飞,E-mail:lslwjyhmu@163.com
作者简介:王一然,女,(1989-),硕士,研究实习员,从事肿瘤学基础的研究。
基金资助:
国家自然科学基金(面上项目)(编号:81372839;81672599);黑龙江省自然科学基金(省留学归国人员科学基金)(编号:LC2017037)

The ratio of neutrophil to lymphocyte in the efficacy and prognosis of concurrent chemoradiotherapy in patients with cervical cancer and its clinical significance

WANG Yiran^1,2, HUANG Wei³, YIN Lei^1,2, LIU Lin⁴, ZHOU Xiaoping⁵, NIU Xingjian⁵, YANG Yue^1,2, AN Weiwei^1,2, JI Hongfei^1,2

1.Institute of Cancer Prevention and Treatment,Harbin Medical University,Harbin 150081,China;
2.Heilongjiang Academy of Medical Sciences;
3.Department of Gynecological Oncology,Harbin Medical University Cancer Hospital;
4.Department of Medical Imaging Science,Harbin Medical University;
5.Department of Medical Oncology,Harbin Medical University Cancer Hospital.

Received:2018-04-02 Online:2018-10-28 Published:2018-10-23

摘要/Abstract

摘要： 目的探讨宫颈癌患者治疗前中性粒细胞与淋巴细胞比值(Neutrophils to lymphocytes ratio,NLR)与预后的关系。方法选取247例哈尔滨医科大学附属肿瘤医院收治的接受同步放化疗的宫颈癌患者(IB-ⅢB期),回顾性分析临床病理资料和随访记录。绘制ROC曲线评价患者接受治疗前NLR对患者预后的预测效果;分析患者临床病理资料与NLR水平的关系;应用Kaplan-Meier法绘制生存曲线,建立Cox比例风险模型分析患者预后影响因素。结果 ROC曲线结果显示治疗前NLR对宫颈癌患者的预后有较好的诊断价值(AUC=0.591,P=0.014),NLR最佳分界值为2.08,是总生存期(OS)和无进展生存期(PFS)的影响因素(HR=2.469,P＜0.001;HR=2.663,P＜0.001);按照高低NLR分组,发现在宫颈癌患者中NLR水平与临床分期、分化程度和组织学类型等有关(P＜0.05);高NLR组OS和PFS显著低于低NLR组(P＜0.001),其中PF方案化疗患者治疗前NLR水平对预后具有很好的提示作用。结论治疗前NLR水平可作为宫颈癌患者(尤其是PF化疗方案)的预后风险评价指标。

关键词: 宫颈癌, 中性粒细胞与淋巴细胞数比值, 预后

Abstract: Objective The aim of the study was to investigate the relationship between the pre-treatment neutrophil to lymphocyte ratio(NLR)and prognosis in patients with cervical cancer.Methods A total of 247 patients with cervical cancer who received concurrent chemoradiotherapy(ⅠB~ⅢB stage)admitted to the Affiliated Tumor Hospital of Harbin Medical University were enrolled.The clinical pathological data and follow-up records were retrospectively analyzed.The receiver operating characteristic(ROC)curve was used to evaluate the predictive effect of NLR on the prognosis of patients before treatment.The relationship between clinicopathological data and NLR level was also analyzed.The Kaplan-Meier survival analysis and Cox regression analysis were used to assess the prognosis of patients.The survival curve was drawn by Kaplan-Meier method,and the Cox proportional hazard model was established to analyze the prognostic factors.Results The Results of ROC curve showed that NLR had a good diagnostic value for the prognosis of patients with cervical cancer(AUC=0.591,P=0.014),the optimal cut-off value of NLR was 2.08,and the hazard ratio(HR)for overall survival(OS)and patients with high no progression in NLR Survival(PFS)was 2.469 and 2.663,respectively(P＜0.001);According to the high and low NLR group,levels of NLR were found to be significantly associated with survival,treatment regimen,clinical stage,and histological type in cervical cancer patients;OS and PFS time were significantly lower than that in the low NLR group(P＜0.001),and the pre-treatment NLR level in patients with PF regimen had a good prognosis for prognosis.Conclusion The levels of pre-treatment can be used as a prognostic risk assessment index for cervical cancer patients(especially PF chemotherapy).

Key words: Cervical carcinoma, NLR, Prognosis

中图分类号:

R737.33

王一然, 黄维, 尹蕾, 刘琳, 周晓平, 牛星鉴, 杨悦, 安巍巍, 姬宏飞. 中性粒细胞与淋巴细胞比值对宫颈癌患者同步放化疗疗效及预后判断的临床意义[J]. 实用肿瘤学杂志, 2018, 32(5): 404-409.

WANG Yiran, HUANG Wei, YIN Lei, LIU Lin, ZHOU Xiaoping, NIU Xingjian, YANG Yue, AN Weiwei, JI Hongfei. The ratio of neutrophil to lymphocyte in the efficacy and prognosis of concurrent chemoradiotherapy in patients with cervical cancer and its clinical significance[J]. PRACTICAL ONCOLOGY JOURNAL, 2018, 32(5): 404-409.

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中性粒细胞与淋巴细胞比值对宫颈癌患者同步放化疗疗效及预后判断的临床意义

The ratio of neutrophil to lymphocyte in the efficacy and prognosis of concurrent chemoradiotherapy in patients with cervical cancer and its clinical significance

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