Li Yong-Jiang, Yang Xi, Zhang Wen-Biao, Yi Cheng, Wang Feng, Li Ping
Department of Oncology, West China Hospital, Sichuan University, Chengdu, People's Republic of China.
Cancer Manag Res. 2017 Sep 28;9:443-451. doi: 10.2147/CMAR.S146827. eCollection 2017.
Cancer-related systemic inflammation responses have been correlated with cancer development and progression. The prognostic significance of several inflammatory indicators, including neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), Glasgow Prognostic Score (GPS), C-reactive protein to albumin ratio (CRP/Alb ratio), lymphocyte-monocyte ratio (LMR), and neutrophil-platelet score (NPS), were found to be correlated with prognosis in several cancers. However, the prognostic role of these inflammatory biomarkers in Ewing sarcoma has not been evaluated. This study enrolled 122 Ewing patients. Receiver operating characteristic (ROC) analysis was generated to determine optimal cutoff values; areas under the curves (AUCs) were assessed to show the discriminatory ability of the biomarkers; Kaplan-Meier analysis was conducted to plot the survival curves; and Cox multivariate survival analysis was performed to identify independent prognostic factors. The optimal cutoff values of CRP/Alb ratio, NLR, PLR, and LMR were 0.225, 2.38, 131, and 4.41, respectively. CRP/Alb ratio had a significantly larger AUC than NLR, PLR, LMR, and NPS. Higher levels of CRP/Alb ratio (hazard ratio [HR] 2.41, =0.005), GPS (HR 2.27, =0.006), NLR (HR 2.07, =0.013), and PLR (HR 1.85, =0.032) were significantly correlated with poor prognosis. As the biomarkers had internal correlations, only the CRP/Alb ratio was involved in the multivariate Cox analysis and remained an independent prognostic indicator. The study demonstrated that CRP/Alb ratio, GPS, and NLR were effective prognostic indicators for patients with Ewing sarcoma, and the CRP/Alb ratio was the most robust prognostic indicator with a discriminatory ability superior to that of the other indicators; however, PLR, LMR, and NPS may not be suitable as prognostic indicators in Ewing sarcoma.
癌症相关的全身炎症反应与癌症的发生和发展相关。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）、格拉斯哥预后评分（GPS）、C反应蛋白与白蛋白比值（CRP/Alb比值）、淋巴细胞与单核细胞比值（LMR）以及中性粒细胞与血小板评分（NPS）在内的几种炎症指标的预后意义，已被发现与多种癌症的预后相关。然而，这些炎症生物标志物在尤因肉瘤中的预后作用尚未得到评估。本研究纳入了122例尤因肉瘤患者。通过绘制受试者工作特征（ROC）曲线来确定最佳临界值；评估曲线下面积（AUC）以显示生物标志物的鉴别能力；进行Kaplan-Meier分析以绘制生存曲线；并进行Cox多因素生存分析以确定独立的预后因素。CRP/Alb比值、NLR、PLR和LMR的最佳临界值分别为0.225、2.38、131和4.41。CRP/Alb比值的AUC显著大于NLR、PLR、LMR和NPS。较高水平的CRP/Alb比值（风险比[HR] 2.41，P = 0.005）、GPS（HR 2.27，P = 0.006）、NLR（HR 2.07，P = 0.013）和PLR（HR 1.85，P = 0.032）与不良预后显著相关。由于这些生物标志物之间存在内在相关性，多因素Cox分析仅纳入了CRP/Alb比值，其仍然是一个独立的预后指标。该研究表明，CRP/Alb比值、GPS和NLR是尤因肉瘤患者有效的预后指标，且CRP/Alb比值是最可靠的预后指标，其鉴别能力优于其他指标；然而，PLR、LMR和NPS可能不适用于作为尤因肉瘤的预后指标。
