术前血小板与淋巴细胞比值作为软组织肉瘤的预后因素优于中性粒细胞与淋巴细胞比值。
Preoperative platelet-lymphocyte ratio is superior to neutrophil-lymphocyte ratio as a prognostic factor for soft-tissue sarcoma.
作者信息
Que Yi, Qiu Haibo, Li Yuanfang, Chen Yongming, Xiao Wei, Zhou Zhiwei, Zhang Xing
机构信息
Department of Gastric and Pancreatic Surgery, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, 651 East Dongfeng Road, Guangzhou, 510060, China.
State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, 651 East Dongfeng Road, Guangzhou, 510060, China.
出版信息
BMC Cancer. 2015 Oct 2;15:648. doi: 10.1186/s12885-015-1654-6.
BACKGROUND
Inflammation can promote tumor growth, invasion, angiogenesis and even metastasis. Inflammatory markers have been identified as prognostic indicators in various malignances. This study compared the usefulness of platelet-lymphocyte ratio (PLR) with that of neutrophil-lymphocyte ratio (NLR) for predicting outcomes of patients who underwent radical resection for soft tissue sarcoma (STS).
METHODS
We included 222 STS patients in this retrospective study. Kaplan-Meier curves and multivariate Cox proportional models were used to calculate overall survival (OS) and disease free survival (DFS).
RESULTS
In univariate analysis, elevated PLR and NLR were both significantly associated with decreased OS. In multivariate analysis, PLR (HR: 2.60; 95 % CI: 1.17-5.74, P = 0.019) but not NLR was still identified as independent predictors of outcome. Median OS was 62 and 76 months for the high PLR and low PLR groups, respectively. High PLR and NLR were both significantly associated with shorter DFS in univariate analysis, with median DFS of 18 and 57 months in the high PLR and low PLR groups. In multivariate analysis, elevated PLR (HR: 1.77; 95 % CI: 1.05-2.97, P = 0.032) was also related to decreased DFS.
DISCUSSION
Our findings provide a new and valuable clue for diagnosing and monitoring STS. Prediction of disease progression is not only determined by the use of clinical or histopathological factors including tumor grade, tumor size, and tumor site but also by host-response factors such as performance status, weight loss, and systemic inflammatory response. They also significantly affect clinical outcomes. Thus, PLR can be used to enhance clinical prognostication. Furthermore, the PLR can be assessed from peripheral blood tests that are routinely available without any other complicated expenditure, thus providing lower cost and greater convenience for the prognostication.
CONCLUSION
Elevated preoperative PLR as an independent prognostic factor is superior to NLR in predicting clinical outcome in patients with STS.
背景
炎症可促进肿瘤生长、侵袭、血管生成甚至转移。炎症标志物已被确定为多种恶性肿瘤的预后指标。本研究比较了血小板淋巴细胞比值（PLR）与中性粒细胞淋巴细胞比值（NLR）在预测软组织肉瘤（STS）根治性切除患者预后方面的效用。
方法
我们在这项回顾性研究中纳入了222例STS患者。采用Kaplan-Meier曲线和多变量Cox比例模型来计算总生存期（OS）和无病生存期（DFS）。
结果
在单变量分析中，PLR和NLR升高均与OS降低显著相关。在多变量分析中，PLR（风险比：2.60；95%置信区间：1.17 - 5.74，P = 0.019）而非NLR仍被确定为预后的独立预测因素。高PLR组和低PLR组的中位OS分别为62个月和76个月。在单变量分析中，高PLR和NLR均与较短的DFS显著相关，高PLR组和低PLR组的中位DFS分别为18个月和57个月。在多变量分析中，PLR升高（风险比：1.77；95%置信区间：1.05 - 2.97，P = 0.032）也与DFS降低有关。
讨论
我们的研究结果为STS的诊断和监测提供了一个新的有价值的线索。疾病进展的预测不仅取决于临床或组织病理学因素的使用，包括肿瘤分级、肿瘤大小和肿瘤部位，还取决于宿主反应因素，如身体状况、体重减轻和全身炎症反应。它们也显著影响临床结果。因此，PLR可用于加强临床预后评估能力。此外，PLR可通过常规的外周血检测来评估，无需任何其他复杂费用，从而为预后评估提供更低成本和更大便利。
结论
术前PLR升高作为独立的预后因素，在预测STS患者的临床结果方面优于NLR。
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