Department of Obstetrics and Gynecology, National Defense Medical College Hospital, Tokorozawa, Japan.
Department of Clinical Oncology, National Defense Medical College Hospital, Tokorozawa, Japan,
Oncology. 2019;96(5):259-267. doi: 10.1159/000497184. Epub 2019 Mar 20.
The pretreatment neutrophil-to-lymphocyte ratio (NLR) and the platelet-to-lymphocyte ratio (PLR) have been reported to be useful as markers for prognostic factors and metastasis in several cancers. The aim of this study was to identify the predictor of lymph node (LN) metastasis by pretreatment NLR and PLR in patients with endometrial cancer.
Medical charts of the patients with endometrial cancers that received primary surgery at our hospital between 2007 and 2013 were retrospectively analyzed. The cutoff value was calculated from the receiver operating characteristics (ROC) curve. Clinicopathological parameters including inflammatory markers were evaluated for LN metastasis using multiple logistic regression analysis.
Among 197 patients enrolled in the study, LN metastasis was observed in 25 patients (13%). ROC curves demonstrated that the best cutoff value of NLR for predicting LN metastasis was 2.18 and that of PLR was 206. In univariate analysis, several pathological factors, NLR, and PLR were identified as predictors of LN metastasis. In multiple logistic regression analysis, lymphovascular invasion and NLR were found to be significantly correlated with LN metastasis (p = 0.002, 0.039).
A higher pretreatment NLR was identified as a predictor of LN metastasis in endometrial cancers. Although further study is needed to confirm the results, NLR could be a candidate clinical marker for detection of LN metastasis.
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)在多种癌症中被报道为预后因素和转移的有用标志物。本研究旨在通过术前 NLR 和 PLR 来确定子宫内膜癌患者淋巴结(LN)转移的预测因素。
回顾性分析 2007 年至 2013 年期间在我院接受初次手术的子宫内膜癌患者的病历。使用接收者操作特征(ROC)曲线计算临界值。使用多因素逻辑回归分析评估包括炎症标志物在内的临床病理参数与 LN 转移的关系。
在纳入研究的 197 名患者中,25 名(13%)患者发生 LN 转移。ROC 曲线表明,预测 LN 转移的 NLR 最佳截断值为 2.18,PLR 为 206。在单因素分析中,几个病理因素、NLR 和 PLR 被确定为 LN 转移的预测因素。在多因素逻辑回归分析中,淋巴血管侵犯和 NLR 与 LN 转移显著相关(p=0.002,0.039)。
术前 NLR 升高被认为是子宫内膜癌 LN 转移的预测因素。尽管需要进一步研究来证实这些结果,但 NLR 可能是检测 LN 转移的候选临床标志物。