Spolverato G, Maqsood H, Kim Y, Margonis Ga, Luo T, Ejaz A, Pawlik T M
The Johns Hopkins University School of Medicine, Baltimore, Maryland.
J Surg Oncol. 2015 Jun;111(7):868-74. doi: 10.1002/jso.23900. Epub 2015 Apr 10.
We sought to determine whether Neutrophil-lymphocyte ratio (NLR) or platelet-lymphocyte ratio (PLR) were associated with outcomes of patients undergoing surgery for a hepatopancreatico-biliary (HPB) malignancy.
Between 2000 and 2013, 452 patients who underwent an HPB procedure for a malignant indication were identified. Clinicopathological characteristics, NLR, and PLR, as well as short- and long-term outcomes were analyzed. High NLR and PLR were classified using a cut-off value of 5 and 190, respectively, based on ROC curve analysis.
Patients with low versus high NLR and PLR had similar baseline characteristics with regard to performance status and tumor stage (all P > 0.05). Elevated PLR (HR = 1.40) tends to be association with shorter recurrence-free survival (RFS) (P = 0.05), whereas NLR was not a predictor of shorter RFS. Differently, both elevated NLR (HR = 1.94) and PLR (HR = 1.79) were associated with worse overall survival (OS) (both P < 0.05). Patients with NLR ≥5 and those with PLR ≥190 had a significantly shorter OS compared to patients with NLR <5 and PLR <190, respectively (log-rank test, both P < 0.05). Moreover, patients who had both NLR and PLR elevated had worse OS compared to patients with either one or none inflammatory markers elevated (log-rank P = 0.02).
Elevated NLR and PLR were predictors of worse long-term outcome among patients with HPB malignancy undergoing resection.
我们试图确定中性粒细胞与淋巴细胞比值（NLR）或血小板与淋巴细胞比值（PLR）是否与接受肝胰胆（HPB）恶性肿瘤手术患者的预后相关。
在2000年至2013年期间，确定了452例因恶性指征接受HPB手术的患者。分析了临床病理特征、NLR和PLR以及短期和长期预后。根据ROC曲线分析，分别使用5和190的临界值对高NLR和PLR进行分类。
低NLR和PLR患者与高NLR和PLR患者在体能状态和肿瘤分期方面具有相似的基线特征（所有P>0.05）。PLR升高（HR = 1.40）往往与无复发生存期（RFS）缩短相关（P = 0.05），而NLR不是RFS缩短的预测指标。不同的是，NLR升高（HR = 1.94）和PLR升高（HR = 1.79）均与总生存期（OS）较差相关（两者P<0.05）。与NLR<5和PLR<190的患者相比，NLR≥5和PLR≥190的患者OS明显缩短（对数秩检验，两者P<0.05）。此外，与炎症标志物升高一项或均未升高的患者相比，NLR和PLR均升高的患者OS更差（对数秩P = 0.02）。
NLR和PLR升高是接受切除术的HPB恶性肿瘤患者长期预后较差的预测指标。
