Gao Yongyin, Zhang Hongdian, Li Yue, Wang Dandan, Ma Yinlu, Chen Qing
Department of Cardio-pulmonary Functions, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and therapy, Tianjin, China.
Department of Esophageal Cancer, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and therapy, Tianjin, China.
Oncotarget. 2017 Apr 18;8(16):27489-27501. doi: 10.18632/oncotarget.14225.
This study aimed at analyzing the relationship between preoperative pulmonary function and systemic inflammatory response (SIR) biomarkers, such as neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and lymphocyte-to-monocyte ratio (LMR) in patients with non-small cell lung cancer (NSCLC). Furthermore, the prognostic significance of these markers was also examined. The medical records of 358 NSCLC patients, who underwent curative lung resection, were retrospectively analyzed. Pulmonary function test values <80% of the predicted values were used to indicate impairment. A receiver operating characteristic curve was used to determine the thresholds of the SIR biomarkers. Univariate and multivariate survival analyses were then performed to identify the factors associated with the overall survival (OS). Furthermore, one prognostic model based on independent prognostic factors was established to classify the patients into low-, intermediate-, and high-risk groups. Results demonstrated that, preoperative forced vital capacity (FVC) was simultaneously associated with NLR, PLR, and LMR (P < 0.05). Multivariate analysis identified age, lymph node status, FVC, and NLR as independent prognostic factors for OS. A subgroup analysis showed that the prognostic value of FVC was independent of age, lymph node status, and NLR. The five-year OS rates for low-, intermediate-, and high-risk groups of prognostic model were 60.9%, 35.9%, and 15.3%, respectively (P < 0.05). Overall, preoperative FVC was an independent prognostic predictor of NSCLC. Significant correlations were observed among preoperative pulmonary function, SIR, and prognosis. Thus, the prognostic model may help us identify risk populations with NSCLC.
本研究旨在分析非小细胞肺癌（NSCLC）患者术前肺功能与全身炎症反应（SIR）生物标志物之间的关系，这些生物标志物包括中性粒细胞与淋巴细胞比值（NLR）、血小板与淋巴细胞比值（PLR）以及淋巴细胞与单核细胞比值（LMR）。此外，还研究了这些标志物的预后意义。回顾性分析了358例行根治性肺切除术的NSCLC患者的病历。肺功能测试值<预测值的80%用于表示肺功能受损。采用受试者工作特征曲线确定SIR生物标志物的阈值。然后进行单因素和多因素生存分析，以确定与总生存期（OS）相关的因素。此外，基于独立预后因素建立了一个预后模型，将患者分为低、中、高风险组。结果表明，术前用力肺活量（FVC）与NLR、PLR和LMR均相关（P<0.05）。多因素分析确定年龄、淋巴结状态、FVC和NLR为OS的独立预后因素。亚组分析显示，FVC的预后价值独立于年龄、淋巴结状态和NLR。预后模型低、中、高风险组的五年OS率分别为60.9%、35.9%和15.3%（P<0.05）。总体而言，术前FVC是NSCLC的独立预后预测指标。术前肺功能、SIR与预后之间存在显著相关性。因此，该预后模型可能有助于我们识别NSCLC风险人群。
