术前NLR、PLR、SII与甲状腺乳头状癌临床病理特征的关系
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摘要
目的研究外周血中性粒细胞和淋巴细胞比值(neutrophil-to-lymphocyte ratio,NLR)、血小板和淋巴细胞比值(platelet-to-lymphocyte ratio,PLR)及系统性免疫性炎症指数(systemic immune-inflammation index,SII)与甲状腺乳头状癌临床病理特征的关系。方法回顾性分析2015年1月—2017年12月在中国人民武装警察部队特色医学中心甲状腺和乳腺外科初次行手术治疗的甲状腺乳头状癌患者临床病理资料,分别讨论NLR、PLR、SII与甲状腺乳头状癌患者临床病理特征的关系。结果术前NLR与甲状腺乳头状癌的双侧癌(P=0.040)和多灶性有关(P<0.001),与患者年龄、性别、肿瘤直径、TNM分期及腺外侵犯、颈部淋巴结转移无关(均P>0.05);术前PLR与患者性别(P=0.019)、颈部淋巴结转移有关(P=0.048),与年龄、肿瘤直径、TNM分期、多灶性、双侧癌和腺外侵犯无关(均P>0.05);术前SII与甲状腺乳头状癌的多灶性(P<0.001)和双侧癌(P=0.002)有关,与患者年龄、性别、肿瘤直径、TNM分期以及腺外侵犯、颈部淋巴结转移无关(均P>0.05)。结论术前外周血NLR、PLR、SII水平可反映甲状腺乳头状癌的生物学特征,较高的NLR、PLR、SII值与较差的病理组织学特征和更加侵袭性的临床生物学行为密切相关。
Objective To investigate the correlation of the preoperative neutrophil-to-lymphocyte ratio(NLR), platelet-to-lymphocyte ratio(PLR) and systemic immune-inflammation index(SII) with clinicopathological characteristics in patients with papillary thyroid cancer. Methods A retrospective study was performed to analyze the clinical data of patients with thyroid papillary carcinoma who accepted surgery treatment firstly in the Affiliated Hospital of Logistics University of PAP from January 2015 to December 2017. The relationship between NLR, PLR and SII and clinicopathological characteristics of papillary thyroid carcinoma was discussed. Results The preoperative NLR significantly correlated with bilateral carcinoma(P=0.040) and multifocality(P<0.001) in papillary thyroid cancer, but not with the age, sex, tumor size, TNM staging, extrathyroidal invasion and cervical lymph node metastasis(all P>0.05). The preoperative PLR obviously correlated with the sex(P=0.019) and cervical lymph node metastasis(P=0.048) in papillary thyroid cancer, but not with the age, tumor size, TNM staging, multifocality, Bilateral carcinoma, and extrathyroidal invasion(all P>0.05). The preoperative SII correlated with multifocality(P<0.001) and bilateral carcinoma(P=0.002) in papillary thyroid cancer, but not with the age, sex, tumor size, TNM staging, extrathyroidal invasion, and cervical lymph node metastasis in papillary thyroid cancer(all P>0.05). Conclusion The preoperative levels of NLR, PLR and SII can reflect the biological characteristics of papillary thyroid carcinoma. The increased NLR, PLR and SII levels in papillary carcinomas might correlate with the poorer histopathological profile and more aggressive clinical behavior.
Objective To investigate the correlation of the preoperative neutrophil-to-lymphocyte ratio(NLR), platelet-to-lymphocyte ratio(PLR) and systemic immune-inflammation index(SII) with clinicopathological characteristics in patients with papillary thyroid cancer. Methods A retrospective study was performed to analyze the clinical data of patients with thyroid papillary carcinoma who accepted surgery treatment firstly in the Affiliated Hospital of Logistics University of PAP from January 2015 to December 2017. The relationship between NLR, PLR and SII and clinicopathological characteristics of papillary thyroid carcinoma was discussed. Results The preoperative NLR significantly correlated with bilateral carcinoma(P=0.040) and multifocality(P<0.001) in papillary thyroid cancer, but not with the age, sex, tumor size, TNM staging, extrathyroidal invasion and cervical lymph node metastasis(all P>0.05). The preoperative PLR obviously correlated with the sex(P=0.019) and cervical lymph node metastasis(P=0.048) in papillary thyroid cancer, but not with the age, tumor size, TNM staging, multifocality, Bilateral carcinoma, and extrathyroidal invasion(all P>0.05). The preoperative SII correlated with multifocality(P<0.001) and bilateral carcinoma(P=0.002) in papillary thyroid cancer, but not with the age, sex, tumor size, TNM staging, extrathyroidal invasion, and cervical lymph node metastasis in papillary thyroid cancer(all P>0.05). Conclusion The preoperative levels of NLR, PLR and SII can reflect the biological characteristics of papillary thyroid carcinoma. The increased NLR, PLR and SII levels in papillary carcinomas might correlate with the poorer histopathological profile and more aggressive clinical behavior.
引文
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[22] WANG S,LI Z,XU R.Human cancer and platelet interaction,a potential therapeutic target[J].Int J Mol Sci,2018,19(4).pii:E1246.
[23] TRéDAN O,MéNéTRIER-CAUX C,RAY-COQUARD I,et al.ELYPSE-7:a randomized placebo-controlled phase IIa trial with CYT107 exploring the restoration of CD4+ lymphocyte count in lymphopenic metastatic breast cancer patients[J].Ann Oncol,2015,26(7):1353-1362.
[24] ZHAO Q T,YUAN Z,ZHANG H,et al.Prognostic role of platelet to lymphocyte ratio in non-small cell lung cancers:A meta-analysis including 3,720 patients[J].Int J Cancer,2016,139(1):164-170.
[25] YODYING H,MATSUDA A,MIYASHITA M,et al.Prognostic significance of neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio in oncologic outcomes of esophageal cancer:a systematic review and meta-analysis[J].Ann Surg Oncol,2016,23(2):646-654.
[26] KIM S M,KIM E H,KIM B H,et al.Association of the preoperative neutrophil-to-ymphocyte count ratio and platelet-to-lymphocyte count ratio with clinicopathological characteristics in patients with papillary thyroid cancer[J].Endocrinol Metab(Seoul),2015,30(4):494-501.
[27] 韩鹏,刘宁青.EGFR、Survivin-甲状腺肿瘤关系的研究现状[J].河北医药,2015,37(5):721-724.
[28] SPIEGEL A,BROOKS M W,HOUSHYAR S,et al.Neutrophils suppress intraluminal NK cell-mediated tumor cell clearance and enhance extravasation of disseminated carcinoma cells[J].Cancer Discov,2016,6(6):630-649.
[29] GALDIERO M R,VARRICCHI G,LOFFREDO S,et al.Potential involvement of neutrophils in human thyroid cancer[J].PLoS One,2018,13(6):e0199740.
[30] 朴美慈,金仁顺.术前NLR、PLR与乳腺癌预后的相关性[J].中国肿瘤临床,2015,42(23):1128-1131.
[31] SHEN M,HU P,DONSKOV F,et al.Tumor-associated neutrophils as a new prognostic factor in cancer:a systematic review and meta-analysis[J].PLoS One,2014,9(6):e98259.
[32] HU B,YANG X R,XU Y,et al.Systemic immune-inflammation index predicts prognosis of patients after curative resection for hepatocellular carcinoma[J].Clin Cancer Res,2014,20(23):6212-6222.
[33] CHEN J H,ZHAI E T,YUAN Y J,et al.Systemic immune-inflammation index for predicting prognosis of colorectal cancer[J].World J Gastroenterol,2017,23(34):6261-6272.
[34] CHEN L,YAN Y,ZHU L,et al.Systemic immune-inflammation index as a useful prognostic indicator predicts survival in patients with advanced gastric cancer treated with neoadjuvant chemotherapy[J].Cancer Manag Res,2017,9:849-867.
[35] GAO Y,ZHANG H,LI Y,et al.Preoperative increased systemic immune-inflammation index predicts poor prognosis in patients with operable non-small cell lung cancer[J].Clin Chim Acta,2018,484:272-277.
[2] AHN H S,KIM H J,WELCH H G.2014 Korea’s thyroid-cancer "epidemic"-screening and overdiagnosis[J].N Engl J Med,2014,371(19):1765-1767.
[3] LIU X,WU Z,LIN E,et al.Systemic prognostic score and nomogram based on inflammatory,nutritional and tumor markers predict cancer-specific survival in stage Ⅱ-Ⅲ gastric cancer patients with adjuvant chemotherapy[J].Clin Nutr,2018.doi:10.1016/j.clnu.2018.07.015.
[4] DOLAN R D,LIM J,MCSORLEY S T,et al.The role of the systemic inflammatory response in predicting outcomes in patients with operable cancer:Systematic review and meta-analysis[J].Sci Rep,2017,7(1):16717.
[5] LIAN L,XIA Y Y,ZHOU C,et al.Application of platelet/lymphocyte and neutrophil/lymphocyte ratios in early diagnosis and prognostic prediction in patients with resectable gastric cancer[J].Cancer Biomark,2015,15(6):899-907.
[6] WANG K,DIAO F,YE Z,et al.Prognostic value of systemic immune inflammation index in patients with gastric cancer[J].Chin J Cancer,2017,36(1):75.
[7] WANG L,WANG C,WANG J,et al.A novel systemic immune-inflammation index predicts survival and quality of life of patients after curative resection for esophageal squamous cell carcinoma[J].J Cancer Res Clin Oncol,2017,143(10):2077-2086.
[8] PERRIER N D,BRIERLEY J D,TUTTLE R M.Differentiated and anaplastic thyroid carcinoma:Major changes in the American Joint Committee on Cancer eighth edition cancer staging manual[J].CA Cancer J Clin,2018,68(1):55-63.
[9] 贾静,陈颖,林露,等.胃癌患者术前NLR PLR RDW值与病理参数的关系[J].中国肿瘤临床,2017,44(2):78-82.
[10] 曹明为,伍丹丹,季梦遥,等.中性粒细胞/淋巴细胞比值与溃疡性结肠炎内镜活动度关系的研究[J].中华全科医学,2017,15(3):390-392,536.
[11] 李文,王璐,张军成,等.术前外周血中性粒细胞及血小板与淋巴细胞比值对子宫内膜癌患者预后的影响[J].医学研究生学报,2018,31(1):60-64.
[12] CUNHA L L,MARCELLO M A,WARD L S.The role of the inflammatory microenvironment in thyroid carcinogenesis[J].Endocr Relat Cancer,2014,21(3):R85-R103.
[13] LIU J F,BA L,LV H,et al.Association between neutrophil-to-lymphocyte ratio and differentiated thyroid cancer:a meta-analysis[J].Sci Rep,2016,6:38551.
[14] 吴伟,张艳君,王冰,等.术前外周血中性粒细胞与淋巴细胞计数比鉴别甲状腺良恶性结节临床价值研究[J].中国实用外科杂志,2016,36(2):227-229,233.
[15] LIU J,DU J,FAN J,et al.The neutrophil-to-lymphocyte ratio correlates with age in patients with papillary thyroid carcinoma[J].ORL J Otorhinolaryngol Relat Spec,2015,77(2):109-116.
[16] KIM J Y,PARK T,JEONG S H,et al.Prognostic importance of baseline neutrophil to lymphocyte ratio in patients with advanced papillary thyroid carcinomas[J].Endocrine,2014,46(3):526-531.
[17] MANATAKIS D K,TSELENI-BALAFOUTA S,BALALIS D,et al.Association of baseline neutrophil-to-lymphocyte ratio with clinicopathological characteristics of papillary thyroid carcinoma[J].Int J Endocrinol,2017,2017:8471235.
[18] 孙威,贺亮,张浩.美国癌症联合委员会甲状腺癌分期系统(第8版)更新解读[J].中国实用外科杂志,2017,37(3):255-258.
[19] HAEMMERLE M,TAYLOR M L,GUTSCHNER T,et al.Platelets reduce anoikis and promote metastasis by activating YAP1 signaling[J].Nat Commun,2017,8(1):310.
[20] RAO X D,ZHANG H,XU Z S,et al.Poor prognostic role of the pretreatment platelet counts in colorectal cancer:A meta-analysis[J].Medicine(Baltimore),2018,97(23):e10831.
[21] BARANYAI Z,JóSA V,TóTH A,et al.Paraneoplastic thrombocytosis in gastrointestinal cancer[J].Platelets,2016,27(4):269-275.
[22] WANG S,LI Z,XU R.Human cancer and platelet interaction,a potential therapeutic target[J].Int J Mol Sci,2018,19(4).pii:E1246.
[23] TRéDAN O,MéNéTRIER-CAUX C,RAY-COQUARD I,et al.ELYPSE-7:a randomized placebo-controlled phase IIa trial with CYT107 exploring the restoration of CD4+ lymphocyte count in lymphopenic metastatic breast cancer patients[J].Ann Oncol,2015,26(7):1353-1362.
[24] ZHAO Q T,YUAN Z,ZHANG H,et al.Prognostic role of platelet to lymphocyte ratio in non-small cell lung cancers:A meta-analysis including 3,720 patients[J].Int J Cancer,2016,139(1):164-170.
[25] YODYING H,MATSUDA A,MIYASHITA M,et al.Prognostic significance of neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio in oncologic outcomes of esophageal cancer:a systematic review and meta-analysis[J].Ann Surg Oncol,2016,23(2):646-654.
[26] KIM S M,KIM E H,KIM B H,et al.Association of the preoperative neutrophil-to-ymphocyte count ratio and platelet-to-lymphocyte count ratio with clinicopathological characteristics in patients with papillary thyroid cancer[J].Endocrinol Metab(Seoul),2015,30(4):494-501.
[27] 韩鹏,刘宁青.EGFR、Survivin-甲状腺肿瘤关系的研究现状[J].河北医药,2015,37(5):721-724.
[28] SPIEGEL A,BROOKS M W,HOUSHYAR S,et al.Neutrophils suppress intraluminal NK cell-mediated tumor cell clearance and enhance extravasation of disseminated carcinoma cells[J].Cancer Discov,2016,6(6):630-649.
[29] GALDIERO M R,VARRICCHI G,LOFFREDO S,et al.Potential involvement of neutrophils in human thyroid cancer[J].PLoS One,2018,13(6):e0199740.
[30] 朴美慈,金仁顺.术前NLR、PLR与乳腺癌预后的相关性[J].中国肿瘤临床,2015,42(23):1128-1131.
[31] SHEN M,HU P,DONSKOV F,et al.Tumor-associated neutrophils as a new prognostic factor in cancer:a systematic review and meta-analysis[J].PLoS One,2014,9(6):e98259.
[32] HU B,YANG X R,XU Y,et al.Systemic immune-inflammation index predicts prognosis of patients after curative resection for hepatocellular carcinoma[J].Clin Cancer Res,2014,20(23):6212-6222.
[33] CHEN J H,ZHAI E T,YUAN Y J,et al.Systemic immune-inflammation index for predicting prognosis of colorectal cancer[J].World J Gastroenterol,2017,23(34):6261-6272.
[34] CHEN L,YAN Y,ZHU L,et al.Systemic immune-inflammation index as a useful prognostic indicator predicts survival in patients with advanced gastric cancer treated with neoadjuvant chemotherapy[J].Cancer Manag Res,2017,9:849-867.
[35] GAO Y,ZHANG H,LI Y,et al.Preoperative increased systemic immune-inflammation index predicts poor prognosis in patients with operable non-small cell lung cancer[J].Clin Chim Acta,2018,484:272-277.