顺铂还是卡铂？中性粒细胞与淋巴细胞比值可能是小细胞肺癌治疗方案选择中的一个有用因素。
Cisplatin or carboplatin? Neutrophil to lymphocyte ratio may serve as a useful factor in small cell lung cancer therapy selection.
作者信息
Pan Zhangchi, Zhang Lu, Liu Chen, Huang Xiaobing, Shen Songfei, Lin Xiaoyan, Shi Chunmei
机构信息
Department of Oncology, Fujian Medical University Union Hospital, Fuzhou, Fujian 350001, P.R. China.
Department of Clinical Laboratories, Fujian Medical University Union Hospital, Fuzhou, Fujian 350001, P.R. China.
出版信息
Oncol Lett. 2019 Aug;18(2):1513-1520. doi: 10.3892/ol.2019.10459. Epub 2019 Jun 7.
The present study aimed to investigate the significance of the neutrophil to lymphocyte ratio (NLR) in peripheral blood of patients with small cell lung cancer (SCLC) when selecting a first-line treatment. A total of 73 patients with SCLC who had complete clinical data and sought treatment at Fujian Medical University Union Hospital between January 2014 and May 2016 were included. Data were retrospectively analyzed, utilizing a receiver operating characteristic curve to determine the NLR cut-off value. Out of the 73 patients, 39 were classified as high-NLR (NLR ≥3.80) and 34 as low-NLR (NLR <3.80). Compared with the high-NLR group, patients in the low-NLR group had a longer progression free survival (PFS); however, there was no statistically significant difference in overall survival (OS) time. Patients with a high NLR had a significantly longer PFS (P=0.021) and OS time (P=0.042) when treated with a etoposide/cisplatin (EP) therapy regimen, compared with those treated with etoposide/carboplatin (EC). PFS was the longest in the high-NLR patients with limited stage (LS; P=0.002). Among the patients receiving the EC regimen, the PFS of the low-NLR group was significantly longer compared with the high-NLR group (P=0.003). Patients in the low-NLR group who received thoracic radiotherapy had a longer PFS (P=0.011), when comparing patients in the low-NLR group who did not receive thoracic radiotherapy, and within this group the therapeutic effect of radiation was the greatest in LS patients. Compared with the high-NLR group, the low-NLR group patients who received cranial radiotherapy had a significantly longer PFS (P=0.039). For the initial evaluation of patients with SCLC, pre-treatment NLR may be of significance for selecting first-line chemotherapy agents. As the present study was retrospective and investigated a limited number of patients, further research and prospective studies are warranted.
本研究旨在探讨小细胞肺癌（SCLC）患者外周血中性粒细胞与淋巴细胞比值（NLR）在一线治疗选择中的意义。纳入2014年1月至2016年5月期间在福建医科大学附属协和医院就诊、临床资料完整且寻求治疗的73例SCLC患者。对数据进行回顾性分析，利用受试者工作特征曲线确定NLR临界值。73例患者中，39例被归类为高NLR组（NLR≥3.80），34例为低NLR组（NLR<3.80）。与高NLR组相比，低NLR组患者的无进展生存期（PFS）更长；然而，总生存期（OS）时间无统计学显著差异。与接受依托泊苷/卡铂（EC）治疗的患者相比，接受依托泊苷/顺铂（EP）治疗方案的高NLR患者的PFS（P=0.021）和OS时间（P=0.042）显著更长。高NLR的局限期（LS）患者的PFS最长（P=0.002）。在接受EC方案治疗的患者中，低NLR组的PFS显著长于高NLR组（P=0.003）。与未接受胸部放疗的低NLR组患者相比，接受胸部放疗的低NLR组患者的PFS更长（P=0.011），且在该组中，放疗对LS患者的治疗效果最佳。与高NLR组相比，接受颅脑放疗的低NLR组患者的PFS显著更长（P=0.039）。对于SCLC患者的初始评估，治疗前NLR可能对一线化疗药物的选择具有重要意义。由于本研究为回顾性研究且调查的患者数量有限，因此有必要进行进一步研究和前瞻性研究。
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