外周血血小板-淋巴细胞比值是胃癌患者化疗敏感性和预后的良好预测指标。
Peripheral Blood Platelet-Lymphocyte Ratio Is Good Predictor of Chemosensitivity and Prognosis in Gastric Cancer Patients.
作者信息
Ohe Yuka, Fushida Sachio, Yamaguchi Takahisa, Kinoshita Jun, Saito Hiroto, Okamoto Koichi, Nakamura Keishi, Tajima Hidehiro, Ninomiya Itasu, Ohta Tetsuo
机构信息
Department of Gastroenterological Surgery, Kanazawa University Hospital, Kanazawa, Japan.
出版信息
Cancer Manag Res. 2020 Feb 20;12:1303-1311. doi: 10.2147/CMAR.S241069. eCollection 2020.
INTRODUCTION
Platelets are one factor promoting tumor development. Conversely, lymphocytes are one factor for immune protection. The peripheral blood platelets-lymphocyte ratio (PLR) is useful as an inflammation/immune indicator to predict postoperative recurrence and prognosis of a variety of malignancies. The peripheral blood neutrophil-lymphocyte ratio (NLR) has also been reported as a useful inflammation/immune indicator. However, there are few studies evaluating the relationship between these peripheral blood indicators and the effectiveness of chemotherapy. Thus, we examined these relationships in gastric cancer patients.
PATIENTS AND METHODS
Between 2005 and 2018, 41 gastric cancer patients treated with preoperative DCS therapy (docetaxel, cisplatin, and S-1) therapy followed by gastrectomy were evaluated. Data for peripheral blood tests prior to the initiation of chemotherapy were used. The effectiveness of chemotherapy was determined using Response Evaluation Criteria in Solid Tumors (RECIST) and the pathological response of primary lesions (Ef grade). The relationship between the blood test results and the effectiveness of chemotherapy was evaluated.
RESULTS
Each optimal cut-off value of peripheral inflammation/immune indicators was calculated through ROC curves. Although the pathological responder (Ef grade 2 or 3) revealed significantly better prognosis than the non-responder (Ef grade 0-1b), no relationship was found between responder according to RECIST and prognosis (=0.014, =0.992). In univariate analysis, a low PLR (<180, =0.005), low NLR (<2.6, =0.019), high lymphocyte (≥1.43, =0.019) and high PNI (≥40, =0.032) were identified as prognostic markers, whereas PLR was the only marker correlated with pathological response (=0.031).
CONCLUSION
PLR obtained prior to chemotherapy might be a useful indicator for predicting chemosensitivity owing to the simplicity of its procedure.
引言
血小板是促进肿瘤发展的一个因素。相反，淋巴细胞是免疫保护的一个因素。外周血血小板与淋巴细胞比值（PLR）作为一种炎症/免疫指标，可用于预测多种恶性肿瘤的术后复发和预后。外周血中性粒细胞与淋巴细胞比值（NLR）也被报道为一种有用的炎症/免疫指标。然而，评估这些外周血指标与化疗疗效之间关系的研究较少。因此，我们在胃癌患者中研究了这些关系。
患者与方法
对2005年至2018年间41例接受术前多西他赛、顺铂和S-1（DCS）治疗后行胃切除术的胃癌患者进行评估。使用化疗开始前外周血检查的数据。采用实体瘤疗效评价标准（RECIST）和原发灶病理反应（Ef分级）来确定化疗疗效。评估血液检查结果与化疗疗效之间的关系。
结果
通过ROC曲线计算外周炎症/免疫指标的每个最佳临界值。尽管病理反应者（Ef分级为2或3）的预后明显优于无反应者（Ef分级为0-1b），但根据RECIST标准的反应者与预后之间未发现相关性（=0.014，=0.992）。在单因素分析中，低PLR（<180，=0.005）、低NLR（<2.6，=0.019）、高淋巴细胞（≥1.43，=0.019）和高PNI（≥40，=0.032）被确定为预后标志物，而PLR是唯一与病理反应相关的标志物（=0.031）。
结论
化疗前获得的PLR可能因其操作简单而成为预测化疗敏感性的有用指标。
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