Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
J Gynecol Oncol. 2019 Nov;30(6):e85. doi: 10.3802/jgo.2019.30.e85.
There is increasing evidence that systemic inflammatory response (SIR) markers are prognostic factors for various types of cancers. This is the first study to evaluate the usefulness of SIR markers for the prognosis of early-stage ovarian clear-cell carcinoma (OCCC).
We retrospectively investigated 83 patients diagnosed with stage I-II OCCC who underwent surgery between 2005 and 2017. Initially, receiver operating characteristic curve analysis for overall survival (OS) was used to determine optimal cut-off values for neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR). Patients were stratified into 2 groups by the cut-off values (NLR=3.26, PLR=160). Univariate and multivariate analyses were performed to elucidate the significance of SIR markers as prognostic factors.
In the median follow-up period of 64.1 months, 16 patients experienced recurrence, and nine patients died. The Kaplan-Meier curve showed that OS of the NLR-low group was significantly longer than the NLR-high group (p=0.021). There was no significant difference in progression-free survival between the 2 groups (p=0.668), but the post-recurrence survival of the NLR-low group was significantly longer than the NLR-high group (p=0.019). Furthermore, multivariate analysis showed that increase in NLR is a significant independent prognostic factor for poor prognosis (hazard ratio=7.437, p=0.017). There was no significant difference between PLR-low and PLR-high group.
Results suggest that NLR can be a significant independent prognostic factor for early-stage OCCC.
越来越多的证据表明全身炎症反应（SIR）标志物是各种癌症的预后因素。这是第一项评估 SIR 标志物对早期卵巢透明细胞癌（OCCC）预后价值的研究。
我们回顾性调查了 2005 年至 2017 年间接受手术治疗的 83 例 I-II 期 OCCC 患者。首先，采用受试者工作特征曲线分析对总生存期（OS）进行分析，以确定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）的最佳截断值。根据截断值（NLR=3.26，PLR=160）将患者分为 2 组。采用单因素和多因素分析阐明 SIR 标志物作为预后因素的意义。
在中位随访 64.1 个月期间，16 例患者复发，9 例患者死亡。Kaplan-Meier 曲线显示 NLR 低组的 OS 明显长于 NLR 高组（p=0.021）。两组间无进展生存期无显著差异（p=0.668），但 NLR 低组的复发后生存时间明显长于 NLR 高组（p=0.019）。此外，多因素分析显示 NLR 升高是预后不良的独立显著预后因素（危险比=7.437，p=0.017）。PLR 低值组与 PLR 高值组之间无显著差异。
结果表明，NLR 可能是早期 OCCC 的一个重要独立预后因素。
