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广泛期小细胞肺癌患者血液学参数与生存的关系。

The Relation between Hemogram Parameters and Survival in Extensive-Stage Small Cell Lung Cancer.

机构信息

Department of Medical Oncology, Yuzuncu Yil University Faculty of Medicine, Van, Turkey,

University of Health Sciences, Department of Medical Oncology, Van Training and Research Hospital, Van, Turkey.

出版信息

Oncol Res Treat. 2019;42(10):506-515. doi: 10.1159/000501595. Epub 2019 Jul 23.

Abstract

PURPOSE

To determine whether hemogram parameters have prognostic effects on survival in patients with extensive-stage small cell lung cancer (ED-SCLC).

METHODS

This retrospective analysis included 113ED-SCLC patients, who were followed in an oncology clinic. The data regarding the baseline patient demographic characteristics, complete blood count (white blood cell, red blood cell, hemoglobin, hematocrit, mean platelet volume, platelet, total neutrophil, total lymphocyte, total monocyte, neutrophil-to-lymphocyte ratio [NLR], platelet-to-lymphocyte ratio [PLR], and monocyte-to-lymphocyte ratio [MLR]), and survival were analyzed. According to the ROC curve drawn for overall survival (OS) analysis, the cutoff values were determined as follows: NLR ≥3, with 71.4% sensitivity and 63.6% specificity; PLR ≥0.150, with 68.1% sensitivity and 52.4% specificity; and MLR ≥0.367, with 64.4% sensitivity and 71.4% specificity.

RESULTS

Of the 113 patients with ED-SCLC, 92 (81.4%) were men and 21 (18.6%) were women. The median age was 65 years (range, 35-81 years). NLR was <3 in 40 (65.4%) patients. Patients with NLR <3 had significantly higher OS than those with NLR ≥3 (15 vs. 5 months, respectively, p < 0.001). Patients with PLR <150 had significantly higher median OS than those with PLR ≥150 (14 vs. 6 months, respectively, p = 0.014). The median OS was significantly greater in patients with MLR <0.367 compared to that in patients with MLR ≥0.367 (11 vs. 6 months, respectively, p = 0.016). In multivariate analysis, NLR was the only factor associated with OS (HR = 2.26, 95% Cl 1.24-4.10).

CONCLUSION

NLR was determined as an independent negative prognostic factor for OS in ED-SCLC patients at diagnosis, thus may help determine disease prognosis as a useful prognostic marker.

摘要

目的

确定全血细胞参数是否对广泛期小细胞肺癌(ED-SCLC)患者的生存具有预后影响。

方法

本回顾性分析纳入了在肿瘤科就诊的 113 例 ED-SCLC 患者。分析了基线患者人口统计学特征、全血细胞计数(白细胞、红细胞、血红蛋白、血细胞比容、平均血小板体积、血小板、总中性粒细胞、总淋巴细胞、总单核细胞、中性粒细胞与淋巴细胞比值[NLR]、血小板与淋巴细胞比值[PLR]和单核细胞与淋巴细胞比值[MLR])以及生存数据。根据总生存(OS)分析绘制的 ROC 曲线,确定了以下截断值:NLR≥3,灵敏度为 71.4%,特异性为 63.6%;PLR≥0.150,灵敏度为 68.1%,特异性为 52.4%;MLR≥0.367,灵敏度为 64.4%,特异性为 71.4%。

结果

在 113 例 ED-SCLC 患者中,92 例(81.4%)为男性,21 例(18.6%)为女性。中位年龄为 65 岁(范围:35-81 岁)。40 例(65.4%)患者的 NLR<3。NLR<3 的患者 OS 明显高于 NLR≥3 的患者(分别为 15 个月和 5 个月,p<0.001)。PLR<150 的患者中位 OS 明显长于 PLR≥150 的患者(分别为 14 个月和 6 个月,p=0.014)。MLR<0.367 的患者中位 OS 明显长于 MLR≥0.367 的患者(分别为 11 个月和 6 个月,p=0.016)。多因素分析显示,NLR 是 OS 的唯一相关因素(HR=2.26,95%CI 1.24-4.10)。

结论

NLR 被确定为 ED-SCLC 患者诊断时 OS 的独立负性预后因素,因此可能有助于确定疾病预后,是一种有用的预后标志物。

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