Bobdey Saurabh, Ganesh Balasubramaniam, Mishra Prabhashankar, Jain Aanchal
Department of Medical Records, Biostatistics and Epidemiology, Tata Memorial Hospital Parel, Mumbai, India.
Int Arch Otorhinolaryngol. 2017 Jan;21(1):21-27. doi: 10.1055/s-0036-1587318. Epub 2016 Aug 16.
Inflammation seems to play a critical role in the development and progression of numerous cancers. Peripheral blood leukocyte count is an easily assessable parameter of systemic inflammatory response. The aim of this study was to investigate whether the pretreatment leukocyte counts can predict the prognosis of patients with oral cavity cancer. Medical records of 471 oral cavity cancer patients diagnosed between January 2007 and December 2008 were retrospectively analyzed. Receiver operating characteristic curve analysis and Cox proportional hazards analyses were applied to evaluate the associations of leukocyte counts with overall survival. The overall five year's survival of the cohort was found to be 49.4%. On univariate analysis, elevated monocyte count (≥500/mm3) and neutrophil-to-lymphocyte ratio (NLR) (>2.38) were associated with poor overall survival (OS) ( = 0.001 and 0.000, respectively). Multivariate Cox proportional hazard analysis showed that higher monocyte and NLR levels were significant independent predictors of worse OS (HR = 1.385, 95% CI = 1.049 - 1.829; < 0.05 and HR = 1.392, 95% CI = 1.045 - 1.855; < 0.05, respectively). The advanced overall stage and lymph nodal involvement were also independent indicators for poor OS. Higher pretreatment monocyte and NLR levels are independent predictors of poor prognosis for patients with oral cavity cancer. Thus, these easily accessed variables can serve as a potent marker to predict the outcomes of oral cancer patients.
炎症似乎在众多癌症的发生和发展过程中起着关键作用。外周血白细胞计数是全身炎症反应的一个易于评估的参数。本研究的目的是调查治疗前白细胞计数是否能够预测口腔癌患者的预后。对2007年1月至2008年12月期间确诊的471例口腔癌患者的病历进行了回顾性分析。应用受试者工作特征曲线分析和Cox比例风险分析来评估白细胞计数与总生存期之间的关联。该队列的总体五年生存率为49.4%。单因素分析显示，单核细胞计数升高（≥500/mm³）和中性粒细胞与淋巴细胞比值（NLR）（>2.38）与较差的总生存期（OS）相关（分别为P = 0.001和0.000）。多因素Cox比例风险分析表明，较高的单核细胞和NLR水平是较差OS的显著独立预测因素（HR = 1.385，95%CI = 1.049 - 1.829；P<0.05和HR = 1.392，95%CI = 1.045 - 1.855；P<0.05）。晚期总体分期和淋巴结受累也是OS较差的独立指标。治疗前较高的单核细胞和NLR水平是口腔癌患者预后不良的独立预测因素。因此，这些易于获取的变量可作为预测口腔癌患者预后的有力标志物。
