Zhu Jie, Lian Lian, Qin Hualong, Wang Wen-Jie, Ren Rui, Xu Meng-Dan, Chen Kai, Duan Weiming, Gong Fei-Ran, Tao Min, Zhi Qiaoming, Wu Meng-Yao, Li Wei
Department of Oncology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215006, P.R. China.
Department of Oncology, Suzhou Xiangcheng People's Hospital, Suzhou, Jiangsu 215000, P.R. China.
Oncol Lett. 2019 Feb;17(2):2244-2256. doi: 10.3892/ol.2018.9858. Epub 2018 Dec 20.
Lung cancer is one of the leading causes of cancer-associated mortality. C-reactive protein (CRP), albumin (ALB), globulin (GLB), lactate dehydrogenase (LDH), neutrophil-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) have been identified as general parameters for systemic inflammatory response (SIR). Furthermore, these parameters are also associated with tumor development and metastasis. The present study aimed to investigate the predictive values of these SIR parameters in patients with resectable lung cancer. In total, 101 patients with resectable lung cancer were recruited in the present study. The patients were divided into two groups according to the median value of pre-treatment CRP, ALB, GLB, LDH, NLR or PLR values. The post-/pre-treatment ratios were defined as the ratio of pre-treatment blood parameter values and the corresponding values obtained following therapy. A ratio of ≤1.1 indicated that the values were not increased, while a ratio of >1.1 suggested that the values were increased following treatment. Patients with lower pre-treatment ALB levels had poorer overall survival (OS) rates, whereas GLB, LDH, CRP, NLR or PLR levels were not associated with outcomes. Whole course treatment (surgery combined with adjuvant chemotherapy) significantly increased the value of ALB, but decreased the value of NLR, whereas it had no effect on the values of LDH, CRP or PLR. Post-/pre-treatment LDH and PLR were associated with outcomes. Post-/pre-treatment ALB, GLB, CRP and NLR were not associated with outcomes. Multivariate analysis revealed that a low pre-treatment ALB level and increased post-/pre-treatment PLR were independent risk factors affecting OS. The receiver operating characteristic curve analysis demonstrated that an ALB value of 47.850 g/l was considered to be the optimal cut-off value for prognosis; the sensitivity was 28.8% and specificity was 95.9%. It was suggested that the pre-treatment ALB and post-/pre-treatment PLR may be potential prognostic factors in resectable lung cancer.
肺癌是癌症相关死亡的主要原因之一。C反应蛋白（CRP）、白蛋白（ALB）、球蛋白（GLB）、乳酸脱氢酶（LDH）、中性粒细胞与淋巴细胞比值（NLR）以及血小板与淋巴细胞比值（PLR）已被确定为全身炎症反应（SIR）的一般参数。此外，这些参数也与肿瘤的发生和转移有关。本研究旨在探讨这些SIR参数对可切除肺癌患者的预测价值。本研究共纳入101例可切除肺癌患者。根据治疗前CRP、ALB、GLB、LDH、NLR或PLR值的中位数将患者分为两组。治疗后/治疗前比值定义为治疗前血液参数值与治疗后相应值的比值。比值≤1.1表明数值未升高，而比值>1.1表明治疗后数值升高。治疗前ALB水平较低的患者总生存率（OS）较差，而GLB、LDH、CRP、NLR或PLR水平与预后无关。全程治疗（手术联合辅助化疗）显著提高了ALB值，但降低了NLR值，而对LDH、CRP或PLR值无影响。治疗后/治疗前LDH和PLR与预后有关。治疗后/治疗前ALB、GLB、CRP和NLR与预后无关。多因素分析显示，治疗前ALB水平低和治疗后/治疗前PLR升高是影响OS的独立危险因素。受试者工作特征曲线分析表明，ALB值47.850 g/l被认为是预后的最佳临界值；敏感性为28.8%，特异性为95.9%。提示治疗前ALB和治疗后/治疗前PLR可能是可切除肺癌的潜在预后因素。
