中性粒细胞/淋巴细胞比值是老年高级别脑胶质瘤患者的独立预后因素。
Neutrophil/Lymphocyte Ratio Is an Independent Prognostic Factor in Elderly Patients with High-Grade Gliomas.
机构信息
Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, China.
Department of Neurosurgery, Xi'an Central Hospital, School of Medicine, Xi'an Jiaotong University, Xi'an, China.
出版信息
World Neurosurg. 2019 Jul;127:e261-e267. doi: 10.1016/j.wneu.2019.03.085. Epub 2019 Mar 19.
OBJECTIVE
The present study was performed to investigate the prognostic role of the preoperative neutrophil/lymphocyte ratio (NLR) in elderly patients with high-grade glioma.
METHODS
We collected the data from elderly patients (age ≥65 years) who had been diagnosed with high-grade glioma in our hospital from December 2014 to January 2018. The preoperative NLR was evaluated in univariate and multivariate models to examine their effect on overall survival (OS).
RESULTS
The study included 135 elderly patients (World Health Organization grade III, n = 22; grade IV, n = 113) with a mean age 70.61 ± 4.60 years. The mean NLR was 3.98 ± 3.28. The optimal NLR cutoff for predicting OS was 3. Of the 135 patients, 65 (48.1%) had a baseline NLR of ≥3 and 70 (51.9%) a baseline NLR <3. For patients with an NLR of ≥3 and NLR <3, the mean OS was 9.6 months and 17.1 months, respectively. The results showed that age, gender, tumor location, preoperative Karnofsky performance scale score, extent of resection (EOR), and postoperative adjuvant therapy were not associated with the NLR. The tumor grade, neutrophil count, and lymphocyte count were significantly associated with the NLR (P < 0.001). On univariate analysis, tumor grade, preoperative Karnofsky performance scale score ≥80, EOR, frontal tumor, adjuvant radiotherapy plus temozolomide, NLR of ≥3, and lymphocyte count of ≥1.6 × 10/L were significantly associated with OS. On multivariate analysis, tumor grade, EOR, adjuvant radiotherapy plus temozolomide, NLR of ≥3, and lymphocyte count of ≥1.6 × 10/L were still associated with OS after excluded related parameters.
CONCLUSIONS
A high NLR was an unfavorable predictor of prognosis for elderly patients with high-grade glioma.
目的
本研究旨在探讨术前中性粒细胞/淋巴细胞比值（NLR）对老年高级别脑胶质瘤患者的预后价值。
方法
我们收集了 2014 年 12 月至 2018 年 1 月在我院诊断为高级别脑胶质瘤的老年患者（年龄≥65 岁）的数据。在单变量和多变量模型中评估术前 NLR，以检查其对总生存（OS）的影响。
结果
本研究纳入了 135 名老年患者（世界卫生组织分级 III 级，n=22；IV 级，n=113），平均年龄 70.61±4.60 岁。平均 NLR 为 3.98±3.28。预测 OS 的最佳 NLR 临界值为 3。在 135 名患者中，65 名（48.1%）基线 NLR≥3，70 名（51.9%）基线 NLR<3。对于 NLR≥3 和 NLR<3 的患者，中位 OS 分别为 9.6 个月和 17.1 个月。结果显示，年龄、性别、肿瘤位置、术前卡氏功能状态评分、切除程度（EOR）和术后辅助治疗与 NLR 无关。肿瘤分级、中性粒细胞计数和淋巴细胞计数与 NLR 显著相关（P<0.001）。单因素分析显示，肿瘤分级、术前卡氏功能状态评分≥80、EOR、额叶肿瘤、辅助放化疗、NLR≥3 和淋巴细胞计数≥1.6×10/L 与 OS 显著相关。多因素分析显示，排除相关参数后，肿瘤分级、EOR、辅助放化疗、NLR≥3 和淋巴细胞计数≥1.6×10/L 仍与 OS 相关。
结论
高 NLR 是老年高级别脑胶质瘤患者预后不良的预测指标。
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