Zhang Xueqing, Li Jinluan, Peng Qingqin, Huang Yunxia, Tang Lirui, Zhuang Qingyang, Lin Feifei, Lin Xijin, Du Kaixin, Wu Junxin
Department of Radiation Oncology, Fujian Medical University Cancer Hospital, Fujian Cancer Hospital, Fuzhou 350014, China,
Department of Radiation Oncology, First Hospital of Quanzhou Affiliated to Fujian Medical University, Quanzhou 362000, China.
Cancer Manag Res. 2018 Dec 24;11:191-199. doi: 10.2147/CMAR.S187559. eCollection 2019.
The inflammatory status of patients with cancer appears to affect cancer progression and patient prognosis. We examined the characteristics of cancer-associated systemic and local inflammation and its impact on the overall survival (OS) of patients with locally advanced rectal cancer (LARC) who received neoadjuvant radiotherapy (nRT).
Seventy-six consecutive LARC patients who received nRT from February 2012 to September 2015 were retrospectively analyzed. The peripheral neutrophil-to-lymphocyte ratio (NLR) was determined at diagnosis, and the CD8+ T-cell count was determined from surgical specimens. Factors associated with OS were identified by univariate and multivariate Cox regression.
The median follow-up time was 23.0 months (range: 2-59), and the overall 5-year OS rate was 68.6% (95% CI =46.06-91.14). Patients with a high NLR (≥2.0) and a low CD8+ T-cell count (<9%) had a significantly worse 5-year OS than those with a low NLR and a high CD8+ T-cell count (=0.005). NLR was also associated with lymphovascular invasion (=0.014) and T stage (=0.047), and the CD8+ T-cell count was associated with mucinous adenocarcinoma (=0.005) and T stage (=0.049). An NLR <2.0 was associated with pathological complete regression after nRT (=0.039). Multivariate Cox regression indicated that NLR (=0.025), CD8+ T-cell count (=0.018), age (=0.020), lymphovascular invasion (=0.038), and T stage (=0.011) were independently associated with OS.
A high NLR and a low CD8+ T-cell count were significantly associated with poor survival in our population of patients with LARC. Measurement of markers of systemic and local inflammation might help to predict the prognosis of patients with LARC after nRT.
癌症患者的炎症状态似乎会影响癌症进展和患者预后。我们研究了癌症相关的全身和局部炎症的特征及其对接受新辅助放疗（nRT）的局部晚期直肠癌（LARC）患者总生存期（OS）的影响。
回顾性分析了2012年2月至2015年9月期间连续接受nRT的76例LARC患者。在诊断时测定外周血中性粒细胞与淋巴细胞比值（NLR），并从手术标本中测定CD8 + T细胞计数。通过单因素和多因素Cox回归确定与OS相关的因素。
中位随访时间为23.0个月（范围：2 - 59个月），总体5年OS率为68.6%（95%CI = 46.06 - 91.14）。NLR高（≥2.0）且CD8 + T细胞计数低（<9%）的患者5年OS明显差于NLR低且CD8 + T细胞计数高的患者（P = 0.005）。NLR还与淋巴管侵犯（P = 0.014）和T分期（P = 0.047）相关，CD8 + T细胞计数与黏液腺癌（P = 0.005）和T分期（P = 0.049）相关。NLR <2.0与nRT后病理完全缓解相关（P = 0.039）。多因素Cox回归表明，NLR（P = （此处原文有误，推测应为P = 0.025））、CD8 + T细胞计数（P = 0.018）、年龄（P = 0.020）、淋巴管侵犯（P = 0.038）和T分期（P = 0.011）与OS独立相关。
在我们的LARC患者群体中，高NLR和低CD8 + T细胞计数与较差的生存率显著相关。测量全身和局部炎症标志物可能有助于预测LARC患者接受nRT后的预后。
