Wang Gaoxiang, Xiong Ran, Wu Hanran, Xu Guangwen, Li Caiwei, Sun Xiaohui, Xie Mingran
Department of Thoracic Surgery, Anhui Provincial Hospital Affiliated to Anhui Medical University, Hefei 230001, China.
Zhongguo Fei Ai Za Zhi. 2018 Aug 20;21(8):588-593. doi: 10.3779/j.issn.1009-3419.2018.08.04.
Previous studies have shown that the neutrophil-to-lymphocyte ratio (NLR) has a significant impact on the prognosis of many malignant tumors such as gastric cancer, colorectal cancer and pancreatic cancer, but the study on the prognosis of patients with resectable lung adenocarcinoma is less. The aim of this study is to investigate the correlation between the NLR and the clinicopathologic features of adenocarcinoma of lung patients who underwent radical pneumonectomy. Furthermore, this study aimed to clarify the predictive and prognostic significance of NLR in patients who underwent pneumonectomy for lung adenocarcinoma.
This study reviewed the medical records of 163 patients with lung adenocarcinoma who underwent pneumonectomy. The receiver operating characteristic (ROC) curve and Youden index were used to determine the cut-off value of the NLR. Survival curves were described by Kaplan-Meier method and compared by Log-rank test. The univariate and multivariate analyses were performed with the Cox proportional hazard model to identify the prognostic factors.
When the NLR value was 2.96, the Youden index was maximal, with a sensitivity of 77.5% and a specificity of 75.9%. The 5-year survival rate in the low NLR group was higher than that in the high NLR group (P<0.05). The univariate and multivariate analyses showed that TNM staging and NLR were independent factors in predicting survival rate.
The NLR value was a simple and useful tool to predict the prognosis of lung adenocarcinoma after radical pneumonectomy.
既往研究表明,中性粒细胞与淋巴细胞比值(NLR)对胃癌、结直肠癌和胰腺癌等多种恶性肿瘤的预后有显著影响,但关于可切除肺腺癌患者预后的研究较少。本研究旨在探讨NLR与接受根治性肺叶切除术的肺腺癌患者临床病理特征之间的相关性。此外,本研究旨在阐明NLR在接受肺叶切除术的肺腺癌患者中的预测和预后意义。
本研究回顾了163例行肺叶切除术的肺腺癌患者的病历。采用受试者工作特征(ROC)曲线和约登指数确定NLR的临界值。采用Kaplan-Meier法绘制生存曲线,并通过Log-rank检验进行比较。采用Cox比例风险模型进行单因素和多因素分析,以确定预后因素。
当NLR值为2.96时,约登指数最大,灵敏度为77.5%,特异度为75.9%。低NLR组的5年生存率高于高NLR组(P<0.05)。单因素和多因素分析显示,TNM分期和NLR是预测生存率的独立因素。
NLR值是预测根治性肺叶切除术后肺腺癌预后的一种简单且有用的工具。