术前炎症指标在合并肝侵犯的胆囊癌中的预后价值。
The prognostic value of preoperative inflammatory indexes in gallbladder carcinoma with hepatic involvement.
机构信息
Department of Oncology and State Key Laboratory of Biotherapy, Cancer Center, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China.
Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.
出版信息
Cancer Biomark. 2018;22(3):551-557. doi: 10.3233/CBM-181230.
BACKGROUND
Neutrophil-Lymphocyte Ratio (NLR) and Platelet-Lymphocyte Ratio (PLR) have been considered as indicators for prognosis in various cancers. However, the prognostic values of NLR and PLR have never been tested in gallbladder carcinoma (GBC) with hepatic involvement.
OBJECTIVE
The aim of the current study was to assess the prognostic significance of NLR, PLR, and other candidate biomarkers in GBC with liver involvement.
METHODS
Receiver operating characteristic (ROC) curve analyses were utilized to pinpoint the cut-off values for NLR, PLR, and Monocyte-Lymphocyte Ratio (MLR). Univariate analyses were employed to estimate the impact of NLR, PLR, MLR, and other inflammatory indexes on median survival. Multivariate analyses were used to verify the independent prognostic predictors.
RESULTS
Eighty four patients were enrolled from 2009 to 2017. The cut-off values for NLR, PLR, and MLR were 3.20, 117.75, and 0.25, respectively. Univariate analyses revealed that TNM stage, NLR, PLR, MLR, lactate dehydrogenase, alkaline phosphatase, and carcinoembryonic antigen were significantly associated with decreased survival in GBC with hepatic involvement. Advanced TNM stage (P< 0.001) and elevated preoperative NLR (P= 0.002) were significantly associated with lower median survival periods, as revealed by multivariate analyses.
CONCLUSIONS
These findings suggest that preoperative NLR may be an independent prognostic factor in evaluating prognosis in GBC with liver involvement.
背景
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）已被认为是多种癌症预后的指标。然而，NLR 和 PLR 在伴有肝侵犯的胆囊癌（GBC）中的预后价值尚未得到检验。
目的
本研究旨在评估 NLR、PLR 和其他候选生物标志物在伴有肝侵犯的 GBC 中的预后意义。
方法
采用受试者工作特征（ROC）曲线分析确定 NLR、PLR 和单核细胞与淋巴细胞比值（MLR）的截断值。采用单因素分析估计 NLR、PLR、MLR 和其他炎症指标对中位生存时间的影响。采用多因素分析验证独立的预后预测因子。
结果
本研究共纳入了 2009 年至 2017 年间的 84 例患者。NLR、PLR 和 MLR 的截断值分别为 3.20、117.75 和 0.25。单因素分析显示，TNM 分期、NLR、PLR、MLR、乳酸脱氢酶、碱性磷酸酶和癌胚抗原与伴有肝侵犯的 GBC 患者的生存时间缩短显著相关。多因素分析显示，晚期 TNM 分期（P<0.001）和术前 NLR 升高（P=0.002）与较低的中位生存时间显著相关。
结论
这些发现表明，术前 NLR 可能是评估伴有肝侵犯的 GBC 患者预后的一个独立预后因素。
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