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治疗前低淋巴细胞-单核细胞比率和高血小板-淋巴细胞比率提示早期舌癌患者预后不良。

Low Pretreatment Lymphocyte-Monocyte Ratio and High Platelet-Lymphocyte Ratio Indicate Poor Cancer Outcome in Early Tongue Cancer.

作者信息

Ong Hui Shan, Gokavarapu Sandhya, Wang Li Zhen, Tian Zhen, Zhang Chen Ping

机构信息

Resident, Department of Oral and Maxillofacial-Head & Neck Oncology, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.

Consultant in Head and Neck Oncology Reconstructive Surgery, Department of Surgical Oncology, Krishna Institute of Medical Science, Hyderabad, India.

出版信息

J Oral Maxillofac Surg. 2017 Aug;75(8):1762-1774. doi: 10.1016/j.joms.2016.12.023. Epub 2016 Dec 26.

DOI:10.1016/j.joms.2016.12.023
PMID:28063763
Abstract

PURPOSE

The white blood cell (WBC) indices have been reported to have a prognostic impact in cancer of multiple organs including head and neck cancer; however; site and stage stratification was not attempted, and compelling evidence has shown that early cancers have a different distribution and prognostic ability than late-stage cancers. We studied the prognostic importance of WBC indices in early oral tongue cancers.

PATIENTS AND METHODS

The retrospective data of primary pT1N0 to pT2N0 oral tongue cancers treated between 2009 and 2013 were charted. WBC indices such as the neutrophil count, lymphocyte count (LC), platelet count (PC), and monocyte count, along with derived indices such as the neutrophil-lymphocyte ratio, platelet-lymphocyte ratio (PLR), and lymphocyte-monocyte ratio (LMR), were analyzed by multivariate analysis with other clinicopathologic prognostic factors.

RESULTS

A total of 133 patients fulfilled the inclusion criteria; the minimum follow-up period for living patients was 36 months. A total of 22 patients reported disease relapse, and 11 patients died of disease. Multivariate analysis showed LC (hazard ratio [HR], 0.206; 95% confidence interval [CI], 0.092 to 0.46; P < .001), PC (HR, 1.011; 95% CI, 1.001 to 1.021; P = .026), PLR (HR, 1.012; 95% CI, 1.008 to 1.016; P < .001), and LMR (HR, 0.721; 95% CI, 0.596 to 0.872; P = .001) are significant independent prognostic factors for disease-free survival. Distant metastasis (HR, 9.014; 95% CI, 2.303 to 38.914; P = .004), LC (HR, 0.091; 95% CI, 0.015 to 0.558; P = .01), PC (HR, 1.023; 95% CI, 1.006 to 1.041; P = .009), PLR (HR, 1.016; 95% CI, 1.004 to 1.027; P = .002), and LMR (HR, 0.58; 95% CI, 0.387 to 0.868; P = .008) are significant independent prognostic factors for overall survival.

CONCLUSIONS

Low pretreatment LMR and high PLR indicate poor survival in patients with early tongue cancer. We suggest close follow-up for this subgroup despite radical resection with clear margins.

摘要

目的

据报道,白细胞(WBC)指标对包括头颈癌在内的多个器官的癌症具有预后影响;然而,未尝试按部位和分期进行分层,且有力证据表明早期癌症与晚期癌症在分布和预后能力方面存在差异。我们研究了白细胞指标在早期口腔舌癌中的预后重要性。

患者与方法

记录2009年至2013年间接受治疗的原发性pT1N0至pT2N0口腔舌癌的回顾性数据。对中性粒细胞计数、淋巴细胞计数(LC)、血小板计数(PC)和单核细胞计数等白细胞指标,以及中性粒细胞与淋巴细胞比值、血小板与淋巴细胞比值(PLR)和淋巴细胞与单核细胞比值(LMR)等衍生指标,与其他临床病理预后因素进行多因素分析。

结果

共有133例患者符合纳入标准;存活患者的最短随访期为36个月。共有22例患者报告疾病复发,11例患者死于疾病。多因素分析显示,LC(风险比[HR],0.206;95%置信区间[CI],0.092至0.46;P <.001)、PC(HR,1.011;95% CI,1.001至1.021;P =.026)、PLR(HR,1.012;95% CI,1.008至1.016;P <.001)和LMR(HR,0.721;95% CI,0.596至0.872;P =.001)是无病生存的显著独立预后因素。远处转移(HR,9.014;95% CI,2.303至38.914;P =.004)、LC(HR,0.091;95% CI,0.015至0.558;P =.01)、PC(HR,1.023;95% CI,1.006至1.041;P =.009)、PLR(HR,1.016;95% CI,1.004至1.027;P =.002)和LMR(HR,0.58;95% CI,0.387至0.868;P =.008)是总生存的显著独立预后因素。

结论

术前低LMR和高PLR表明早期舌癌患者生存不良。尽管切缘清晰进行了根治性切除,我们建议对该亚组患者进行密切随访。

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