术前中性粒细胞/白细胞比值和单核细胞/淋巴细胞比值升高预示可切除的非小细胞肺癌患者预后不良：来自大样本的结果。

Elevated pretreatment neutrophil/white blood cell ratio and monocyte/lymphocyte ratio predict poor survival in patients with curatively resected non-small cell lung cancer: Results from a large cohort.

机构信息

Department of Thoracic Surgery, Sun Yat-sen University Cancer Center, Guangzhou, China.

Department of Experimental Research, Sun Yat-sen University Cancer Center, Guangzhou, China.

出版信息

Thorac Cancer. 2017 Jul;8(4):350-358. doi: 10.1111/1759-7714.12454. Epub 2017 May 22.

BACKGROUND

The prognostic values of preoperative neutrophil/lymphocyte ratio (NLR), monocyte/lymphocyte ratio (MLR), and platelet/lymphocyte ratio (PLR) in non-small cell lung cancer (NSCLC) have been previously described. This study assessed the prognostic values of other pretreatment complete blood cell parameters in Chinese patients with curatively resected NSCLC.

METHODS

A total of 1466 consecutive NSCLC patients who received curative surgery from January 1, 2005 to December 31, 2009 with complete data from pretreatment blood tests were enrolled in this retrospective study. Correlations between each blood test parameter and overall survival were examined by Kaplan-Meier method or Cox proportional hazards regression, followed by a stratification analysis of significant variables.

RESULTS

Optimal cut-off values of 0.55 for neutrophil/white blood cell ratio (NWR), 0.28 for lymphocyte/white blood cell ratio (LWR), 0.09 for monocyte/white blood cell ratio (MWR), 2.06 for NLR, 0.35 for MLR, 204.00 for PLR, and 38.25 for platelet/white blood cell ratio (PWR) were identified using X-tile software. Univariate analysis suggested that NWR ≥ 0.55, LWR < 0.28, MWR ≥ 0.09, NLR ≥ 2.06, MLR ≥ 0.35, and PLR ≥ 204.00 predicted a poor prognosis in NSCLC patients. However, only NWR and MLR were identified as independent significant prognostic factors in multivariable analysis, especially in tumor node metastasis stage I and I/II/III NSCLCs.

CONCLUSION

Pretreatment NWR, MWR, LWR, NLR, MLR, and PLR values are associated with poor overall survival for patients with curatively resected NSCLC. NWR and MLR are independent prognostic factors in curatively resected NSCLC.

背景

术前中性粒细胞/淋巴细胞比值（NLR）、单核细胞/淋巴细胞比值（MLR）和血小板/淋巴细胞比值（PLR）在非小细胞肺癌（NSCLC）中的预后价值已被先前描述。本研究评估了在中国接受根治性手术的 NSCLC 患者中其他预处理全血细胞参数的预后价值。

方法

本回顾性研究纳入了 2005 年 1 月 1 日至 2009 年 12 月 31 日期间接受根治性手术且术前血液检查完整的 1466 例连续 NSCLC 患者。通过 Kaplan-Meier 方法或 Cox 比例风险回归检验各血液检查参数与总生存期之间的相关性，然后对有意义的变量进行分层分析。

结果

使用 X-tile 软件确定了中性粒细胞/白细胞比值（NWR）≥0.55、淋巴细胞/白细胞比值（LWR）<0.28、单核细胞/白细胞比值（MWR）≥0.09、NLR≥2.06、MLR≥0.35、PLR≥204.00 和血小板/白细胞比值（PWR）≥38.25 为最佳截断值。单因素分析表明，NWR≥0.55、LWR<0.28、MWR≥0.09、NLR≥2.06、MLR≥0.35 和 PLR≥204.00 预测 NSCLC 患者预后不良。然而，多变量分析仅发现 NWR 和 MLR 是独立的显著预后因素，尤其是在肿瘤淋巴结转移分期 I 期和 I/II/III 期 NSCLC 中。