中性粒细胞与淋巴细胞比值是西班牙裔胃腺癌患者总生存的独立预后因素。

The Neutrophil-Lymphocyte Ratio Is an Independent Prognostic Factor for Overall Survival in Hispanic Patients with Gastric Adenocarcinoma.

作者信息

Ramos-Esquivel A, Cordero-García E, Brenes-Redondo D, Alpízar-Alpízar W

机构信息

Departamento de Farmacología, Escuela de Medicina, Universidad de Costa Rica, Sede Rodrigo Facio, San Pedro, PO BOX 2082, San José, Costa Rica.

Instituto de Investigaciones Farmacéuticas, Facultad de Farmacia, Universidad de Costa Rica, San Pedro, Costa Rica.

出版信息

J Gastrointest Cancer. 2018 Jul 13. doi: 10.1007/s12029-018-0134-z.

DOI:10.1007/s12029-018-0134-z

PMID:30003495

Abstract

INTRODUCTION

High values of neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) are related with poor prognosis in patients with gastric cancer. However, this association has been rarely assessed in Hispanic populations that show important clinicopathological differences to Asian and Caucasian patients. In this study, we determined the prognostic value of these biomarkers in Hispanic patients from Costa Rica.

MATERIALS AND METHODS

We retrieved data regarding pre-treatment NLR and PLR, as well as clinical variables from medical records of 381 consecutive gastric cancer patients treated in four major hospitals in Costa Rica between 2009 and 2012. Univariate and multiple Cox regression analyses were performed to assess the value of NLR and PLR as predictors of overall survival (OS) and disease-free survival (DFS). The best cutoff point was based on the maximization of the Log-rank test.

RESULTS

Median follow-up was 13.21 months. In univariate analysis, a NLR ≥ 5 was associated with reduced DFS (hazard ratio (HR) 2.31; 95% confidence interval (CI) 1.78-3.00; p < 0.001) and poor OS (HR 2.24; 95% CI 1.72-2.92; p < 0.001). Similarly, a PLR ≥ 350 was associated with worse DFS (HR 2.28; 95% CI 1.70-3.06; p < 0.001) and poor OS (HR 2.33; 95% CI 1.73-3.13; p < 0.001). After adjustment for potential confounders, multivariate analysis revealed that only the NLR ≥ 5 was independently associated with worse DFS (HR 1.97; 95% CI 1.44-2.47) and OS (HR 1.59; 95%CI 1.15-2.28).

CONCLUSIONS

NLR ≥ 5 was independently associated with worse OS and DFS in Hispanic patients with gastric cancer.

摘要

引言

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）升高与胃癌患者的不良预后相关。然而，在与亚洲和白种人患者存在重要临床病理差异的西班牙裔人群中，这种关联很少被评估。在本研究中，我们确定了这些生物标志物在来自哥斯达黎加的西班牙裔患者中的预后价值。

材料与方法

我们从2009年至2012年在哥斯达黎加四家主要医院接受治疗的381例连续胃癌患者的病历中检索了关于治疗前NLR和PLR以及临床变量的数据。进行单因素和多因素Cox回归分析，以评估NLR和PLR作为总生存期（OS）和无病生存期（DFS）预测指标的价值。最佳截断点基于对数秩检验的最大化。

结果

中位随访时间为13.21个月。在单因素分析中，NLR≥5与DFS降低相关（风险比[HR] 2.31；95%置信区间[CI] 1.78 - 3.00；p < 0.001）和OS不良相关（HR 2.24；95% CI 1.72 - 2.92；p < 0.001）。同样，PLR≥350与更差的DFS相关（HR 2.28；95% CI 1.70 - 3.06；p < 0.001）和OS不良相关（HR 2.33；95% CI 1.73 - 3.13；p < 0.001）。在对潜在混杂因素进行调整后，多因素分析显示只有NLR≥5与更差的DFS（HR 1.97；95% CI 1.44 - 2.47）和OS（HR 1.59；95% CI 1.15 - 2.28）独立相关。