术前血小板计数与中性粒细胞-淋巴细胞比值联合（COP-NLR）在非小细胞肺癌患者中的预后意义：基于一项大型队列研究

Prognostic Significance of Combination of Preoperative Platelet Count and Neutrophil-Lymphocyte Ratio (COP-NLR) in Patients with Non-Small Cell Lung Cancer: Based on a Large Cohort Study.

作者信息

Zhang Hua, Zhang Lianmin, Zhu Kaikai, Shi Bowen, Yin Yuesong, Zhu Jinfang, Yue Dongsheng, Zhang Bin, Wang Changli

机构信息

Department of Lung Cancer, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin, China; Key Laboratory of Cancer Prevention and Therapy, Tianjin, China; Tianjin Lung Cancer Center, Tianjin, China.

Department of Pediatrics, Tianjin Medical University General Hospital, Tianjin, China.

出版信息

PLoS One. 2015 May 7;10(5):e0126496. doi: 10.1371/journal.pone.0126496. eCollection 2015.

INTRODUCTION

The aim of this study was to investigate the prognostic significance of the combination of the preoperative platelet count and neutrophil-lymphocyte ratio (COP-NLR) for predicting postoperative survival of patients undergoing complete resection for non-small cell lung cancer (NSCLC).

METHODS

The preoperative COP-NLR was calculated on the basis of data obtained.Patients with both an increased platelet count (>30.0 × 104 mm(-3)) and an elevated NLR (>2.3) were assigned a score of 2, and patients with one or neither were assigned as a score of 1 or 0, respectively.

RESULTS

A total of 1238 NSCLC patients were enrolled in this analysis. Multivariate analysis using the 15 clinicolaboratory variables selected by univariate analyses demonstrated that the preoperative COP-NLR was an independent prognostic factor for DFS (HR: 1.834, 95%CI: 1.536 to 2.200, P<0.001) and OS (HR: 1.810, 95%CI: 1.587 to 2.056, P<0.001). In sub-analyses by tumor stage (I, II, IIIA), a significant association was found between DFS and OS and level of COP-NLR in each subgroup (P<0.001, P=0.002, P<0.001 for DFS, respectively; P<0.001, P=0.001, P<0.001 for OS). When the subgroup of patients with high-risk COP-NLR (score of 2) was analyzed, no benefit of adjuvant chemotherapy could be found (P=0.237 for DFS and P=0.165 for OS).

CONCLUSIONS

The preoperative COP-NLR is able to predict the prognosis of patients with NSCLC and divide these patients into three independent groups before surgery. Our results also demonstrate that high-risk patients based on the COP-NLR do not benefit from adjuvant chemotherapy. Independent validation of our findings is warranted.

引言

本研究旨在探讨术前血小板计数与中性粒细胞-淋巴细胞比值（COP-NLR）联合应用对预测接受完全切除的非小细胞肺癌（NSCLC）患者术后生存的预后意义。

方法

根据所获数据计算术前COP-NLR。血小板计数升高（>30.0×10⁴/mm³）且NLR升高（>2.3）的患者得分为2分，有一项异常或两项均无异常的患者分别得1分或0分。

结果

本分析共纳入1238例NSCLC患者。使用单因素分析选出的15个临床实验室变量进行多因素分析显示，术前COP-NLR是DFS（风险比：1.834，95%置信区间：1.536至2.200，P<0.001）和OS（风险比：1.810，95%置信区间：1.587至2.056，P<0.001）的独立预后因素。在按肿瘤分期（I、II、IIIA）进行的亚组分析中，各亚组的DFS和OS与COP-NLR水平之间均存在显著关联（DFS分别为P<0.001、P=0.002、P<0.001；OS分别为P<0.001、P=0.001、P<0.001）。对COP-NLR高危（得分为2分）患者亚组进行分析时，未发现辅助化疗有获益（DFS的P=0.237，OS的P=0.165）。