Yang Songwei, Wu Chuncao, Wang Liang, Shan Dongli, Chen Biao
Department of Bone and Soft Tissue Tumor, Chongqing University Cancer Hospital & Chongqing Cancer Institute & Chongqing Cancer Hospital Chongqing 400030, China.
Department of Pharmacy, Chongqing Traditional Chinese Medicine Hospital Chongqing 400021, China.
Int J Clin Exp Pathol. 2020 Mar 1;13(3):515-524. eCollection 2020.
Pretreatment inflammatory indexes including neutrophil-lymphocyte ratio (NLR), lymphocyte-monocyte ratio (LMR), platelet-lymphocyte ratio (PLR), and systemic immune-inflammation index (SII) are associated with poor outcomes in various malignant tumors, but their prognostic value in patients with osteosarcoma is poorly known. This was a retrospective study of patients with osteosarcoma treated between 01/2010 and 12/2013 at Chongqing University Cancer Hospital. Follow-up was calculated from the date of initial histological diagnosis to December 2018 or death or loss of follow-up. Receiver operating characteristic (ROC) analysis was used to determine the NLR, LMR, PLR, and SII cut-off values (low (L) vs. high (H)). The Kaplan-Meier method was used for survival analysis. Univariable and multivariable Cox analyses were performed to determine the independent prognostic factors. Patients with LNLR had better survival than those with HNLR (median, 38.0 vs. 13.0, P<0.001). Patients with LSII had better survival (26.0 vs. 10.0 months, P=0.001) than those with HSII. The areas under the curves for NLR, LMR, PLR, SII, and ALP were 0.761 (P<0.001), 0.683 (P=0.012), 0.697 (P=0.002), 0.653 (P=0.031), and 0.515 (P=0.837), respectively. In the univariable analyses, Enneking's stage, systemic chemotherapy, surgery, NLR, PLR, LMR, and SII were associated with overall survival (OS). The multivariable analysis showed that HNLR (HR=2.507; 95% CI=1.364-4.606; P=0.003) was independent unfavorable prognostic factors. This preliminary study suggests that NLR is associated with poor prognosis in osteosarcoma. NLR could be a potential prognostic marker of osteosarcoma.
治疗前的炎症指标，包括中性粒细胞与淋巴细胞比值（NLR）、淋巴细胞与单核细胞比值（LMR）、血小板与淋巴细胞比值（PLR）以及全身免疫炎症指数（SII），与多种恶性肿瘤的不良预后相关，但它们在骨肉瘤患者中的预后价值尚不清楚。这是一项对2010年1月至2013年12月在重庆大学附属肿瘤医院接受治疗的骨肉瘤患者的回顾性研究。随访时间从初次组织学诊断日期计算至2018年12月、死亡或失访。采用受试者工作特征（ROC）分析来确定NLR、LMR、PLR和SII的临界值（低（L）与高（H））。采用Kaplan-Meier法进行生存分析。进行单变量和多变量Cox分析以确定独立的预后因素。低NLR患者的生存率高于高NLR患者（中位数，38.0对13.0，P<0.001）。低SII患者的生存率（26.0对10.0个月，P=0.001）高于高SII患者。NLR、LMR、PLR、SII和碱性磷酸酶（ALP）的曲线下面积分别为0.761（P<0.001）、0.683（P=0.012）、0.697（P=0.002）、0.653（P=0.031）和0.515（P=0.837）。在单变量分析中，Enneking分期、全身化疗、手术、NLR、PLR、LMR和SII与总生存期（OS）相关。多变量分析显示，高NLR（HR=2.507；95%CI=1.364-4.606；P=0.003）是独立的不良预后因素。这项初步研究表明，NLR与骨肉瘤的不良预后相关。NLR可能是骨肉瘤的一个潜在预后标志物。
