Department of ENT-Head and Neck Surgery, Glangwilli General Hospital, Hywel Dda University Health Board, Carmarthen, United Kingdom.
Programme Management Office, Hywel Dda University Health Board, Carmarthen, United Kingdom.
ORL J Otorhinolaryngol Relat Spec. 2020;82(5):235-244. doi: 10.1159/000507027. Epub 2020 May 12.
Recent studies have reported that elevated levels of platelets and inflammatory markers are associated with poor treatment outcomes among patients with solid tumours, but reports are conflicting in head and neck cancer (HNC) patients.
To establish if pre-treatment anti-inflammatory markers can be used as a prognostic tool of overall survival and tumour control among HNC patients.
We retrospectively reviewed the pre-treatment platelet/lymphocyte ratio (PLR) and neutrophil/lymphocyte ratio (NLR) of 147 HNC patients from 2014 to 2018 and analysed their association with tumour progression and overall treatment outcomes. The optimal cut-off was established at >200 for high PLR and >2.85 for high NLR.
After adjusting for age, disease stage, and treatment, patients with higher PLR had an almost 3 times higher risk of mortality during the study period than patients with normal PLR (hazard ratio [HR] 2.79, 95% confidence interval [CI] 1.43-5.47, p < 0.01). Furthermore, the patients with higher NLR had an >2.5 times higher risk of mortality than those with normal NLR (HR 2.62, 95% CI 1.19-5.81, p = 0.02).
This observational study shows that elevated PLR and NLR in HNC patients, who were treated with either surgery or primarily chemoradiotherapy, are associated with poor overall survival.
最近的研究报告称，血小板和炎症标志物水平升高与实体瘤患者的治疗结果不佳有关，但在头颈部癌症（HNC）患者中的报告存在矛盾。
确定治疗前的抗炎标志物是否可以作为 HNC 患者总生存率和肿瘤控制的预后工具。
我们回顾性分析了 2014 年至 2018 年间 147 例 HNC 患者的治疗前血小板/淋巴细胞比值（PLR）和中性粒细胞/淋巴细胞比值（NLR），并分析了它们与肿瘤进展和整体治疗结果的关系。最佳截止值为 PLR > 200 和 NLR > 2.85。
在校正年龄、疾病分期和治疗后，与 PLR 正常的患者相比，PLR 较高的患者在研究期间死亡的风险几乎高出 3 倍（风险比 [HR] 2.79，95%置信区间 [CI] 1.43-5.47，p < 0.01）。此外，NLR 较高的患者死亡的风险比 NLR 正常的患者高 2.5 倍以上（HR 2.62，95% CI 1.19-5.81，p = 0.02）。
这项观察性研究表明，接受手术或单纯放化疗治疗的 HNC 患者中，PLR 和 NLR 升高与总体生存率降低有关。
