Jiang Ke, Lei Jianyong, Li Canjun, Shu Kunpeng, Li Wenbin, Zhang Yuwei, Li Zhihui, Gong Rixiang, Zhu Jingqiang
Thyroid and Parathyroid Surgery Center, West China Hospital, Sichuan University, Chengdu, China.
School of Clinical Medicine, Sichuan University, Chengdu, China.
J Surg Oncol. 2017 Sep;116(3):281-287. doi: 10.1002/jso.24683. Epub 2017 May 29.
The significance of inflammation based scores including the neutrophil-to-lymphocyte ratio (NLR), derived neutrophil-to-lymphocyte ratio (dNLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), prognostic nutritional index (PNI), and plasma fibrinogen remains unclear in medullary thyroid carcinoma (MTC). We aimed to compare the prognostic value of these scores.
Seventy-eight patients newly diagnosed as MTC with operation in our institution from May 2009 to September 2016 were retrospectively evaluated. Receiver operating characteristic (ROC) curves and Kaplan-Meier analyses were calculated to compare the prognostic value of these scores.
Increased PLR was predictive of lymph node metastasis (AUC = 0.644, P = 0.022), capsule invasion (AUC = 0.666, P = 0.007), advanced tumor stages (AUC = 0.657, P = 0.011), and recurrence (AUC = 0.655, P = 0.049). Increased fibrinogen was predictive of lymph node metastasis (AUC = 0.669, P = 0.006) and capsule invasion (AUC = 0.631, P = 0.038). Reduced PNI was predictive of recurrence (AUC = 0.655, P = 0.049). Kaplan-Meier analyses and Cox regression analysis revealed that PLR was a significant predictor for recurrence.
PLR, fibrinogen, and PNI are all predictive. Specially, PLR is superior to other inflammation based scores in terms of prognostic ability.
包括中性粒细胞与淋巴细胞比值(NLR)、衍生中性粒细胞与淋巴细胞比值(dNLR)、血小板与淋巴细胞比值(PLR)、淋巴细胞与单核细胞比值(LMR)、预后营养指数(PNI)以及血浆纤维蛋白原在内的炎症相关评分在甲状腺髓样癌(MTC)中的意义尚不清楚。我们旨在比较这些评分的预后价值。
回顾性评估了2009年5月至2016年9月在我院新诊断并接受手术的78例MTC患者。计算受试者工作特征(ROC)曲线和Kaplan-Meier分析以比较这些评分的预后价值。
PLR升高可预测淋巴结转移(AUC = 0.644,P = 0.022)、包膜侵犯(AUC = 0.666,P = 0.007)、肿瘤晚期(AUC = 0.657,P = 0.011)以及复发(AUC = 0.655,P = 0.049)。纤维蛋白原升高可预测淋巴结转移(AUC = 0.669,P = 0.006)和包膜侵犯(AUC = 0.631,P = 0.038)。PNI降低可预测复发(AUC = 0.655,P = 0.049)。Kaplan-Meier分析和Cox回归分析显示,PLR是复发的重要预测指标。
PLR、纤维蛋白原和PNI均具有预测性。特别是,PLR在预后能力方面优于其他基于炎症的评分。