Liu Dan, Jin Jing, Zhang Li, Li Lei, Song Juan, Li Weimin
Department of Pulmonary & Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, China.
Lab of Pathology, West China Hospital, Sichuan University, Chengdu, China.
Cell Physiol Biochem. 2018;46(4):1595-1605. doi: 10.1159/000489207. Epub 2018 Apr 20.
BACKGROUND/AIMS: The objectives of this study were to evaluate the impact of the neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) on overall survival (OS) and to explore the value of changes in the NLR and PLR with treatment as a response indicator.
A total of 934 patients were eligible for retrospective analysis between 2008 and 2014. The pretreatment and post-treatment PLR and NLR in all patients were calculated based on complete blood counts. Univariate and multivariate Cox regression analyses were performed to determine the associations of the PLR and NLR with OS.
The pretreatment NLR and PLR were correlated with different disease status and response to chemotherapy. Patients with lower NLR and PLR had a significantly better complete response (CR) rate to chemotherapy versus those with a higher NLR and PLR (p< 0.001). The NLR and PLR were sustained in patients who obtained a CR compared with moderate or poor response patients. The lower NLR of pretreatment was independently associated with a favourable prognosis in whole patients with lung cancer (HR: 0.69, 95% CI, 0.55-0.85, p< 0.001). In the patients under control after chemotherapy, the NLR of post-chemotherapy had a greater impact on survival, and the low NLR level maintained during chemotherapy was identified a predictor for favourable survival. PLR was not an independent prognostic indicator in the whole cohort or any subgroups.
Our results suggested that NLR was well-connected with outcomes and response to chemotherapy in patients with lung cancer. As a response indicator, NLR may predict benefit from chemotherapy and improve patient selection.
背景/目的：本研究旨在评估中性粒细胞与淋巴细胞比值（NLR）和血小板与淋巴细胞比值（PLR）对总生存期（OS）的影响，并探讨NLR和PLR随治疗的变化作为反应指标的价值。
2008年至2014年间共有934例患者符合回顾性分析条件。根据全血细胞计数计算所有患者治疗前和治疗后的PLR和NLR。进行单因素和多因素Cox回归分析以确定PLR和NLR与OS的关联。
治疗前NLR和PLR与不同疾病状态及化疗反应相关。NLR和PLR较低的患者化疗完全缓解（CR）率显著高于NLR和PLR较高的患者（p<0.001）。与反应中等或较差的患者相比，获得CR的患者NLR和PLR保持稳定。治疗前较低的NLR与所有肺癌患者的良好预后独立相关（HR：0.69，95%CI，0.55-0.85，p<0.001）。在化疗后病情得到控制的患者中，化疗后的NLR对生存影响更大，化疗期间维持的低NLR水平被确定为良好生存的预测指标。PLR在整个队列或任何亚组中均不是独立的预后指标。
我们的结果表明，NLR与肺癌患者的预后和化疗反应密切相关。作为反应指标，NLR可预测化疗获益并改善患者选择。
