外周血NLR、PLR与食管小细胞癌临床预后的关系
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摘要
目的 探讨食管小细胞癌(SCEC)患者治疗前血小板淋巴细胞比值(PLR)、外周血中性粒细胞淋巴细胞比值(NLR)与预后的关系及其临床意义。方法 回顾性分析2004年1月至2016年6月间52例SCEC的病历资料,治疗前采集患者外周血检测血小板、淋巴细胞和中性粒细胞,计算NLR、PLR,根据中位值分为高NLR组、PLR组及低NLR组、PLR组。采用Kaplan-Meier法计算生存,差异行Log-rank检验。单因素和多因素分析影响SCEC患者总生存期(OS)的预后因素。结果 SCCE患者高NLR组(NLR≥3.1)患者28例,低NLR组(NLR<3.1)患者24例;高PLR组(PLR≥135.8)患者26例,低PLR组(PLR<135.8)患者26例。与低NLR、低PLR组比较,高NLR、高PLR组患者多处于广泛期(P<0.05)。单因素分析结果显示,年龄≥60岁、广泛期、肿瘤位于食管上段、未接受化疗、未接受放疗、NLR≥3.1、PLR≥135.8是SCCE预后不良的影响因素(P<0.05)。Cox多因素分析结果显示:年龄(RR=2.825,95%CI:1.319～6.048,P=0.008)、分期(RR=3.774,95%CI:1.074～13.266,P=0.038)、放疗与否(RR=0.453,95%CI:0.211～0.970,P=0.042)及NLR(RR=2.647,95%CI:1.234～5.676,P=0.012)是影响SCCE患者OS的独立预后因素。结论 NLR、PLR升高的SCCE患者OS较短,其中NLR升高是SCEC患者OS的独立不良预后因素。
Objective To investigate the relationship between platelet lymphocyte ratio(PLR), peripheral blood neutrophil lymphocyte ratio(NLR) and prognosis in patients with small cell esophageal cancer(SCEC) before treatment and its clinical significance. Methods The clinical data of 52 cases of SCCE from January 2004 to June 2016 were retrospectively analyzed. Before treatment, platelets, lymphocytes and neutrophils were detected in peripheral blood of the patients, and NLR and PLR were calculated. According to the median value, they were divided into high NLR group, PLR group, low NLR group and PLR group. The survival was calculated by Kaplan-Meier method, and the difference was tested by Log-rank test. Univariate and multivariate analysis of prognostic factors affecting overall survival(OS) in SCEC patients. Results In SCEC, 28 patients were in high NLR group(NLR≥3.1), 24 patients in low NLR group(NLR <3.1), 26 patients in high PLR group(PLR≥135.8) and 26 patients in low PLR group(PLR<135.8). Compared with the low NLR and low PLR groups, the high NLR and high PLR groups were in extensive stage(P<0.05). Univariate analysis showed that age(≥60 years old), extensive stage, tumors located in the upper esophagus, no chemotherapy, no radiotherapy, NLR(≥3.1), PLR(≥135.8) were the influencing factors of poor prognosis of SCEC(P<0.05). Cox multivariate analysis showed that age(RR=2.825,95%CI:1.319-6.048,P=0.008), stage(RR=3.774,95%CI:1.074-13.266,P=0.038), radiotherapy(RR=0.453,95%CI:0.211-0.970,P=0.042) and NLR(RR=2.647,95%CI:1.234-5.676,P=0.012) were independent prognostic factors for OS in SCEC patients. Conclusion The OS of SCEC patients with elevated NLR and PLR was shorter, and the elevated NLR was an independent prognostic factor for OS of SCEC patients.
Objective To investigate the relationship between platelet lymphocyte ratio(PLR), peripheral blood neutrophil lymphocyte ratio(NLR) and prognosis in patients with small cell esophageal cancer(SCEC) before treatment and its clinical significance. Methods The clinical data of 52 cases of SCCE from January 2004 to June 2016 were retrospectively analyzed. Before treatment, platelets, lymphocytes and neutrophils were detected in peripheral blood of the patients, and NLR and PLR were calculated. According to the median value, they were divided into high NLR group, PLR group, low NLR group and PLR group. The survival was calculated by Kaplan-Meier method, and the difference was tested by Log-rank test. Univariate and multivariate analysis of prognostic factors affecting overall survival(OS) in SCEC patients. Results In SCEC, 28 patients were in high NLR group(NLR≥3.1), 24 patients in low NLR group(NLR <3.1), 26 patients in high PLR group(PLR≥135.8) and 26 patients in low PLR group(PLR<135.8). Compared with the low NLR and low PLR groups, the high NLR and high PLR groups were in extensive stage(P<0.05). Univariate analysis showed that age(≥60 years old), extensive stage, tumors located in the upper esophagus, no chemotherapy, no radiotherapy, NLR(≥3.1), PLR(≥135.8) were the influencing factors of poor prognosis of SCEC(P<0.05). Cox multivariate analysis showed that age(RR=2.825,95%CI:1.319-6.048,P=0.008), stage(RR=3.774,95%CI:1.074-13.266,P=0.038), radiotherapy(RR=0.453,95%CI:0.211-0.970,P=0.042) and NLR(RR=2.647,95%CI:1.234-5.676,P=0.012) were independent prognostic factors for OS in SCEC patients. Conclusion The OS of SCEC patients with elevated NLR and PLR was shorter, and the elevated NLR was an independent prognostic factor for OS of SCEC patients.
引文
[1] Feng JF,Huang Y,Chen QX.Preoperative platelet lymphocyte ratio (PLR) is superior to neutrophil lymphocyte ratio (NLR) as a predictive factor in patients with esophageal squamous cell carcinoma[J].World J Surg Oncol,2014,12(1):1-6.
[2] Mcmillan DC.The systemic inflammation-based Glasgow Prognostic Score:a decade of experience in patients with cancer[J].Cancer Treat Rev,2013,39(5):534-540.
[3] 彭维忠,杨浩洁,张克兰,等.外周血NLR或PLR与结直肠癌预后的相关性研究进展[J].中国免疫学杂志,2017,33(12):1902-1906.
[4] 易福梅,顾阳春,陈森,等.治疗前后NLR和PLR对进展期非小细胞肺癌一线化疗疗效及预后的预测价值[J].中国肺癌杂志,2018,21(6):481-492.
[5] 杨柳,卢高峰,刘宗文,等.NLR,LMR 和 PLR 与食管鳞癌患者预后的关系[J].安徽医科大学学报,2018,53(3):415-419
[6] Rajwa P,■yczkowski M,Paradysz A,,et al.Evaluation of the prognostic value of LMR,PLR,NLR,and dNLR in urothelial bladder cancer patients treated with radical cystectomy[J].Eur Rev Med Pharmacol Sci,2018,22(10):3027-3037.
[7] Emir S,Aydin M,Can G,et al.Comparison of colorectal neoplastic polyps and adenocarcinoma with regard to NLR and PLR[J].Eur Rev Med Pharmacol Sci,2015,19(19):3613-3618.
[8] Pillay J,Kamp VM,van Hoffen E,et a1.A subset of neutro-phils in human systemic inflammation inhibits t cell responses through mac-1[J].J Clin Invest,2012,122(1):327-336.
[9] Hu H,Yao X,Xie X,et al.Prognostic value of preoperative NLR,dNLR,PLR and CRP in surgical renal cell carcinoma patients[J].World J Urol,2017,35(2):261-270.
[10] Ozmen S,Timur O,Calik I,et al.Neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) may be superior to C-reactive protein (CRP) for predicting the occurrence of differentiated thyroid cancer [J].Endocr Regul,2017,51(3):131-136.
[11] Asher V,Lee J,Innamaa A,et al.Preoperative platelet lymphocyte ratio as an independent prognostic marker in ovarian cancer[J].Clin Transl Oncol,2011,13(7):499-503.
[12] Zhang J,Zhang HY,Li J,et al.The elevated NLR,PLR and PLT May predict the prognosis of patients with colorectal cancer:a systematic review and metaanalysis[J].Oncotarget,2017,8(40):68837-68846.
[13] Duan H,Zhang X,Wang FX,et al.Prognostic role of neutrophil-lymphocyte ratio in operable esophageal squamous cell carcinoma[J].World J Gastroenterol,2015,21(18):5591-5597.
[14] Messager M,Neofytou K,Chaudry M,et al.Prognostic impact of preoperative platelets to lymphocytes ratio(PLR)on survival for oesophageal and junctional carcinoma treated with neoadjuvant chemotherapy:A retrospective monocentric study on 153 patients[J].Eur J Surg Oncol,2015,41(10):1316-1323.
[15] 罗会芹,何义富.前列腺素E2通过EP2反式激活EGFR对食管癌细胞的调控作用及机制研究[D].安徽医科大学,2014.
[16] Owusu-Agyemang P,Cata JP,Fournier KF,et al.Evaluating the impact of total intravenous anesthesia on the clinical outcomes and perioperative NLR and PLR profiles of patients undergoing cytoreductive surgery with hyperthermic intraperitoneal chemotherapy[J].Ann Surg Oncol,2016,23(8):2419-2429.
[2] Mcmillan DC.The systemic inflammation-based Glasgow Prognostic Score:a decade of experience in patients with cancer[J].Cancer Treat Rev,2013,39(5):534-540.
[3] 彭维忠,杨浩洁,张克兰,等.外周血NLR或PLR与结直肠癌预后的相关性研究进展[J].中国免疫学杂志,2017,33(12):1902-1906.
[4] 易福梅,顾阳春,陈森,等.治疗前后NLR和PLR对进展期非小细胞肺癌一线化疗疗效及预后的预测价值[J].中国肺癌杂志,2018,21(6):481-492.
[5] 杨柳,卢高峰,刘宗文,等.NLR,LMR 和 PLR 与食管鳞癌患者预后的关系[J].安徽医科大学学报,2018,53(3):415-419
[6] Rajwa P,■yczkowski M,Paradysz A,,et al.Evaluation of the prognostic value of LMR,PLR,NLR,and dNLR in urothelial bladder cancer patients treated with radical cystectomy[J].Eur Rev Med Pharmacol Sci,2018,22(10):3027-3037.
[7] Emir S,Aydin M,Can G,et al.Comparison of colorectal neoplastic polyps and adenocarcinoma with regard to NLR and PLR[J].Eur Rev Med Pharmacol Sci,2015,19(19):3613-3618.
[8] Pillay J,Kamp VM,van Hoffen E,et a1.A subset of neutro-phils in human systemic inflammation inhibits t cell responses through mac-1[J].J Clin Invest,2012,122(1):327-336.
[9] Hu H,Yao X,Xie X,et al.Prognostic value of preoperative NLR,dNLR,PLR and CRP in surgical renal cell carcinoma patients[J].World J Urol,2017,35(2):261-270.
[10] Ozmen S,Timur O,Calik I,et al.Neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) may be superior to C-reactive protein (CRP) for predicting the occurrence of differentiated thyroid cancer [J].Endocr Regul,2017,51(3):131-136.
[11] Asher V,Lee J,Innamaa A,et al.Preoperative platelet lymphocyte ratio as an independent prognostic marker in ovarian cancer[J].Clin Transl Oncol,2011,13(7):499-503.
[12] Zhang J,Zhang HY,Li J,et al.The elevated NLR,PLR and PLT May predict the prognosis of patients with colorectal cancer:a systematic review and metaanalysis[J].Oncotarget,2017,8(40):68837-68846.
[13] Duan H,Zhang X,Wang FX,et al.Prognostic role of neutrophil-lymphocyte ratio in operable esophageal squamous cell carcinoma[J].World J Gastroenterol,2015,21(18):5591-5597.
[14] Messager M,Neofytou K,Chaudry M,et al.Prognostic impact of preoperative platelets to lymphocytes ratio(PLR)on survival for oesophageal and junctional carcinoma treated with neoadjuvant chemotherapy:A retrospective monocentric study on 153 patients[J].Eur J Surg Oncol,2015,41(10):1316-1323.
[15] 罗会芹,何义富.前列腺素E2通过EP2反式激活EGFR对食管癌细胞的调控作用及机制研究[D].安徽医科大学,2014.
[16] Owusu-Agyemang P,Cata JP,Fournier KF,et al.Evaluating the impact of total intravenous anesthesia on the clinical outcomes and perioperative NLR and PLR profiles of patients undergoing cytoreductive surgery with hyperthermic intraperitoneal chemotherapy[J].Ann Surg Oncol,2016,23(8):2419-2429.