血小板计数与淋巴细胞/单核细胞比值联合对伴有恶性胸腔积液的 IV 期非小细胞肺癌的预后价值。
Prognostic value of platelet count and lymphocyte to monocyte ratio combination in stage IV non-small cell lung cancer with malignant pleural effusion.
机构信息
Division of Pulmonology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
出版信息
PLoS One. 2018 Jul 13;13(7):e0200341. doi: 10.1371/journal.pone.0200341. eCollection 2018.
INTRODUCTION
A combination of platelet and lymphocyte to monocyte ratio (LMR) (abbreviated as COP-LMR) has been recently evaluated as systemic inflammatory marker for prognostication in lung cancer. While previous study on COP-LMR has evaluated its prognostic value in NSCLC patients who underwent curative resections, the combination of these two markers has not been evaluated in advanced NSCLC yet.
OBJECTIVES
In this study, we evaluated the prognostic value of COP-LMR in stage IV NSCLC with malignant pleural effusion under active anticancer treatment.
METHODS
Between January 2012 and July 2016, 217 patients with stage IV NSCLC and MPE undergoing active anticancer treatment were selected for evaluation. If patients had both low LMR (< 2.47) and increased platelet (> 30.0 ×10(4) mm-3), they were assigned to COP-LMR group 2. Patients with one parameter were assigned to COP-LMR group 1. If none, patients were assigned to COP-LMR group 0.
RESULTS
Median overall survival (OS) (P < 0.001), progression free survival (PFS) (P < 0.001) and histological feature (P = 0.003) showed significant differences among COP-LMR groups. For COP-LMR groups 0, 1 and 2, median survival times were 35.9, 14.7 and 7.4 months, respectively, while median progression free times were 19.2, 13.3 and 7.4 months, respectively. Older age, male, low albumin, high CRP and high COP-LMR (0 vs 1, P = 0.021, hazard ratio (HR): 1.822, 95% confidence interval (CI): 1.096-3.027 and 0 vs 2, P = 0.003, HR: 2.464, 95% CI: 1.373-4.421) were independent predictive factors for shorter OS. Age, sex, histology, albumin, or CRP had no significant influence on PFS. High COP-LMR was the significant factor in predicting shorter PFS (0 vs 1, P = 0.116 and 0 vs 2, P = 0.007, HR: 1.902, 95% CI: 1.194-3.028).
CONCLUSIONS
A combination of pretreatment LMR and platelet levels can be used to predict short survival in stage IV NSCLC patients who underwent active anticancer treatment.
简介
血小板与淋巴细胞比值（LMR）和单核细胞比值（MPR）的组合（简称 COP-LMR）最近被评估为肺癌患者的全身性炎症标志物，用于预后判断。虽然之前的研究已经评估了 COP-LMR 在接受根治性切除术的非小细胞肺癌（NSCLC）患者中的预后价值，但这两种标志物的组合尚未在晚期 NSCLC 中进行评估。
目的
本研究评估了在接受积极抗癌治疗的伴有恶性胸腔积液的 IV 期 NSCLC 患者中 COP-LMR 的预后价值。
方法
本研究纳入了 2012 年 1 月至 2016 年 7 月期间接受积极抗癌治疗的 217 例 IV 期 NSCLC 合并恶性胸腔积液的患者。如果患者的 LMR 较低（<2.47）且血小板升高（>30.0×10(4)mm(-3)），则将其分配到 COP-LMR 组 2。如果患者只有一个参数，则分配到 COP-LMR 组 1。如果都没有，则分配到 COP-LMR 组 0。
结果
COP-LMR 组间的总生存时间（OS）（P<0.001）、无进展生存时间（PFS）（P<0.001）和组织学特征（P=0.003）均有显著差异。对于 COP-LMR 组 0、1 和 2，中位生存时间分别为 35.9、14.7 和 7.4 个月，中位无进展生存时间分别为 19.2、13.3 和 7.4 个月。高龄、男性、低白蛋白、高 C 反应蛋白（CRP）和高 COP-LMR（0 与 1，P=0.021，风险比（HR）：1.822，95%置信区间（CI）：1.096-3.027 和 0 与 2，P=0.003，HR：2.464，95%CI：1.373-4.421）是 OS 较短的独立预测因素。年龄、性别、组织学、白蛋白或 CRP 对 PFS 无显著影响。高 COP-LMR 是预测 PFS 较短的显著因素（0 与 1，P=0.116 和 0 与 2，P=0.007，HR：1.902，95%CI：1.194-3.028）。
结论
在接受积极抗癌治疗的 IV 期 NSCLC 患者中，治疗前 LMR 和血小板水平的组合可用于预测生存期较短的患者。
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