Watt David G, Proctor Michael J, Park James H, Horgan Paul G, McMillan Donald C
Academic Unit of Surgery, School of Medicine-University of Glasgow, Glasgow Royal Infirmary, Glasgow, United Kingdom.
PLoS One. 2015 Nov 6;10(11):e0142159. doi: 10.1371/journal.pone.0142159. eCollection 2015.
Recent in-vitro studies have suggested that a critical checkpoint early in the inflammatory process involves the interaction between neutrophils and platelets. This confirms the importance of the innate immune system in the elaboration of the systemic inflammatory response. The aim of the present study was to examine whether a combination of the neutrophil and platelet counts were predictive of survival in patients with cancer.
Patients with histologically proven colorectal cancer who underwent potentially curative resection at a single centre between March 1999 and May 2013 (n = 796) and patients with cancer from the Glasgow Inflammation Outcome Study, who had a blood sample taken between January 2000 and December 2007 (n = 9649) were included in the analysis.
In the colorectal cancer cohort, there were 173 cancer and 135 non-cancer deaths. In patients undergoing elective surgery, cancer-specific survival (CSS) at 5 years ranged from 97% in patients with TNM I disease and NPS = 0 to 57% in patients with TNM III disease and NPS = 2 (p = 0.019) and in patients undergoing elective surgery for node-negative colon cancer from 98% (TNM I, NPS = 0) to 65% (TNM II, NPS = 2) (p = 0.004). In those with a variety of common cancers there were 5218 cancer and 929 non-cancer deaths. On multivariate analysis, adjusting for age and sex and stratified by tumour site, incremental increase in the NPS was significantly associated with poorer CSS (p<0.001).
The neutrophil-platelet score predicted survival in a variety of common cancers and highlights the importance of the innate immune system in patients with cancer.
最近的体外研究表明，炎症过程早期的一个关键检查点涉及中性粒细胞与血小板之间的相互作用。这证实了先天免疫系统在全身性炎症反应形成中的重要性。本研究的目的是检验中性粒细胞和血小板计数的组合是否可预测癌症患者的生存率。
纳入分析的患者包括1999年3月至2013年5月在单一中心接受潜在根治性切除术且组织学确诊为结直肠癌的患者（n = 796），以及格拉斯哥炎症结局研究中2000年1月至2007年12月期间采集过血样的癌症患者（n = 9649）。
在结直肠癌队列中，有173例癌症死亡和135例非癌症死亡。在接受择期手术的患者中，5年癌症特异性生存率（CSS）在TNM I期疾病且中性粒细胞与血小板比值（NPS）= 0的患者中为97%，在TNM III期疾病且NPS = 2的患者中为57%（p = 0.019）；在接受择期手术的淋巴结阴性结肠癌患者中，CSS从98%（TNM I期，NPS = 0）至65%（TNM II期，NPS = 2）（p = 0.004）。在患有多种常见癌症的患者中，有5218例癌症死亡和929例非癌症死亡。多因素分析显示，在调整年龄和性别并按肿瘤部位分层后，NPS的递增与较差的CSS显著相关（p<0.001）。
中性粒细胞 - 血小板评分可预测多种常见癌症患者的生存率，并突出了先天免疫系统在癌症患者中的重要性。
