Zhang Gui-Ming, Zhu Yao, Ma Xiao-Cheng, Qin Xiao-Jian, Wan Fang-Ning, Dai Bo, Sun Li-Jiang, Ye Ding-Wei
From the Department of Urology, Fudan University Shanghai Cancer Center (GMZ, YZ, XJQ, FNW, BD, DWY); Department of Oncology, Shanghai Medical College, Fudan University, Shanghai (YZ, XJQ, FNW, BD, DWY); and Department of Urology, The Affiliated Hospital of Qingdao University, Qingdao, China (XCM, LJS).
Medicine (Baltimore). 2015 Oct;94(41):e1473. doi: 10.1097/MD.0000000000001473.
The pretreatment neutrophil-to-lymphocyte ratio (NLR) is reportedly associated with the clinical outcomes of many cancers. However, it has not been widely investigated whether the pretreatment NLR is associated with the pathological characteristics of prostate cancer (PCa) and biochemical recurrence in PCa patients receiving radical prostatectomy (RP).In this cohort study, a total of 1688 PCa patients who had undergone RP were analyzed retrospectively, and a subset of 237 of these patients were evaluated to determine the relationship between pretreatment NLR and biochemical recurrence. Patients were divided into a high-NLR group (NLR ≥2.36) and a low-NLR group (NLR < 2.36) according to the pretreatment NLR. The association between the pretreatment NLR and pathological stage and lymph node involvement was evaluated using logistic regression analysis. Time of biochemical recurrence was determined using the Kaplan-Meier method. Cox's proportional hazard regression model was used to compare the time of biochemical recurrence between the groups.As compared with patients in the low-NLR group, those in the high-NLR group had an increased risk of pT3-4 disease (odds ratio (OR), 1.883; 95% confidence interval (CI), 1.419-2.500; P < 0.001), and a 1.7-fold increased risk of lymph node involvement (OR, 1.685; 95% CI, 1.101-2.579; P = 0.016). For the subset of 237 patients, those with a high NLR showed a significantly shorter median biochemical recurrence-free survival time (51.9 months) than those with a low NLR (76.5 months; log-rank test, P = 0.019). However, multivariate analysis indicated that the NLR was not an independent predictor of biochemical recurrence (hazard ratio, 1.388; 95% CI, 0.909-2.118; P = 0.129).Our findings suggest that the pretreatment NLR may be associated with pathological stage and lymph node involvement in PCa patients receiving RP, and that PCa patients with a high NLR may have a higher rate of biochemical recurrence following RP than those with a low NLR.
据报道，治疗前中性粒细胞与淋巴细胞比值（NLR）与多种癌症的临床结局相关。然而，对于接受根治性前列腺切除术（RP）的前列腺癌（PCa）患者，治疗前NLR是否与PCa的病理特征及生化复发相关，目前尚未得到广泛研究。在这项队列研究中，我们回顾性分析了1688例接受RP的PCa患者，并对其中237例患者进行了评估，以确定治疗前NLR与生化复发之间的关系。根据治疗前NLR将患者分为高NLR组（NLR≥2.36）和低NLR组（NLR＜2.36）。采用逻辑回归分析评估治疗前NLR与病理分期及淋巴结受累之间的关联。使用Kaplan-Meier方法确定生化复发时间。采用Cox比例风险回归模型比较两组之间的生化复发时间。与低NLR组患者相比，高NLR组患者发生pT3-4期疾病的风险增加（比值比（OR），1.883；95%置信区间（CI），1.419 - 2.500；P＜0.001），淋巴结受累风险增加1.7倍（OR，1.685；95%CI，1.101 - 2.579；P = 0.016）。对于237例患者的亚组分析，高NLR患者的生化无复发生存时间中位数（51.9个月）显著短于低NLR患者（76.5个月；对数秩检验，P = 0.019）。然而，多因素分析表明，NLR不是生化复发的独立预测因素（风险比，1.388；95%CI，0.909 - 2.118；P = 0.129）。我们的研究结果表明，治疗前NLR可能与接受RP的PCa患者的病理分期及淋巴结受累相关，且高NLR的PCa患者RP后生化复发率可能高于低NLR患者。
