术前中性粒细胞与淋巴细胞比值和血小板与淋巴细胞比值与 3 级和 4 级髓母细胞瘤的预后相关。
Preoperative Neutrophil to Lymphocyte Ratio and Platelet to Lymphocyte Ratio are Associated with the Prognosis of Group 3 and Group 4 Medulloblastoma.
机构信息
Department of Neurosurgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, 450052, China.
Department of Pathology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, 450052, China.
出版信息
Sci Rep. 2019 Sep 13;9(1):13239. doi: 10.1038/s41598-019-49733-6.
Inflammation and immunoreaction markers were correlated with the survival of patients in many tumors. However, there were no reports investigating the relationships between preoperative hematological markers and the prognosis of medulloblastoma (MB) patients based on the molecular subgroups (WNT, SHH, Group 3, and Group 4). A total 144 MB patients were enrolled in the study. The differences of preoperative hematological markers among molecular subgroups of MB were compared by One-way ANOVA method. Kaplan-Meier method was used to calculate the curves of progression free survival (PFS) and overall survival (OS). The comparison of survival rates in different groups were conducted by the Log-rank test. Multivariate analysis was used to evaluate independent prognostic factors. Increased preoperative NLR (neutrophil-to-lymphocyte ratio, PFS, P = 0.004, OS, P < 0.001) and PLR (platelet-to-lymphocyte ratio, PFS, P = 0.028, OS, P = 0.003) predicted poor prognosis in patients with MB, while preoperative MLR (monocyte-to-lymphocyte ratio), MPV (mean platelet volume), PDW (platelet distribution width), and AGR (albumin-to-globulin ratio) were revealed no predictive value on the prognosis of patients with MB. Furthermore, high preoperative NLR and PLR predicted unfavorable prognosis in childhood MB patients. However, preoperative NLR and PLR were not associated with the prognosis in adult MB patients. Multivariate analysis demonstrated preoperative NLR (PFS, P = 0.029, OS, P = 0.005) and PLR (PFS, P = 0.023, OS, P = 0.005) were the independent prognostic factors in MB patients. Emphatically, the levels of preoperative NLR and PLR in Group 3 MB were significantly higher than those in WNT MB. High preoperative NLR was associated with unfavorable OS in Group 3 (P = 0.032) and Group 4 (P = 0.027) tumors. Similarly, increased preoperative PLR predicted poor PFS (P = 0.012) and OS (P = 0.009) in Group 4 tumors. Preoperative NLR and PLR were the potential prognostic markers for MB patients. Preoperative NLR and PLR were significantly associated with the survival of Group 3 and Group 4 tumors.
在许多肿瘤中，炎症和免疫反应标志物与患者的生存相关。然而，基于分子亚组（WNT、SHH、Group 3 和 Group 4），目前尚无研究报道术前血液学标志物与成神经管细胞瘤（MB）患者预后之间的关系。本研究共纳入 144 例 MB 患者。采用单因素方差分析方法比较 MB 分子亚组之间术前血液学标志物的差异。采用 Kaplan-Meier 法计算无进展生存期（PFS）和总生存期（OS）曲线。通过对数秩检验比较不同组的生存率。采用多变量分析评估独立的预后因素。术前 NLR（中性粒细胞与淋巴细胞比值，PFS，P=0.004，OS，P<0.001）和 PLR（血小板与淋巴细胞比值，PFS，P=0.028，OS，P=0.003）升高预示 MB 患者预后不良，而术前 MLR（单核细胞与淋巴细胞比值）、MPV（平均血小板体积）、PDW（血小板分布宽度）和 AGR（白蛋白与球蛋白比值）对 MB 患者的预后无预测价值。此外，术前 NLR 和 PLR 水平高预示儿童 MB 患者预后不良。然而，术前 NLR 和 PLR 与成人 MB 患者的预后无关。多变量分析表明，术前 NLR（PFS，P=0.029，OS，P=0.005）和 PLR（PFS，P=0.023，OS，P=0.005）是 MB 患者的独立预后因素。值得注意的是，Group 3 MB 患者术前 NLR 和 PLR 水平明显高于 WNT MB。高术前 NLR 与 Group 3（P=0.032）和 Group 4（P=0.027）肿瘤的不良 OS 相关。同样，术前 PLR 升高预示着 Group 4 肿瘤的不良 PFS（P=0.012）和 OS（P=0.009）。术前 NLR 和 PLR 是 MB 患者的潜在预后标志物。术前 NLR 和 PLR 与 Group 3 和 Group 4 肿瘤的生存显著相关。
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