Chen Z-Q, Yu X-S, Mao L-J, Zheng R, Xue L-L, Shu J, Luo Z-W, Pan J-Y
Department of Intensive Care Unit, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, Zhejiang, People's Republic of China.
Clin Transl Oncol. 2021 Jan;23(1):139-147. doi: 10.1007/s12094-020-02405-8. Epub 2020 May 29.
Neutrophil-lymphocyte ratio (NLR) has shown a good prognostic value in many different type of malignancies. The purpose of this study was to investigate the relationship between NLR and the outcome of critically ill patients with cancer.
We performed a single-institution, retrospective study of 1317 adult critically ill patients with cancer and determined the optimal cut-off for NLR by X-tile software. Propensity score matching (PSM) and inverse probabilities of treatment weighting (IPTW) were performed to control confounders. Cox proportional hazards model was used to evaluate the relationship between NLR and 28-day, 6-month and 1-year all-cause mortality. Kaplan-Meier method, subgroup analysis, and receiver operating characteristics (ROC) analysis were applied to assess the prognostic value of NLR.
The cut-off value for NLR was 17.6. Cox proportional hazards model demonstrated that high NLR (> 17.6) was independently associated with 28-day, 6-month and 1-year all-cause mortality with hazard ratio (HR) of 1.58 (1.29, 1.94), 1.51 (1.28, 1.77) and 1.45 (1.25, 1.69), respectively. The results were consistent with survival analyses (p < 0.001, log-rank test). The ROC analyses showed that the discrimination abilities of NLR were better than other blood-based biomarkers.
NLR is a promising prognostic indicator of survival in unselected critical ill patients with cancer.
中性粒细胞与淋巴细胞比值（NLR）在许多不同类型的恶性肿瘤中已显示出良好的预后价值。本研究的目的是探讨NLR与癌症重症患者预后之间的关系。
我们对1317例成年癌症重症患者进行了单中心回顾性研究，并通过X-tile软件确定了NLR的最佳临界值。采用倾向评分匹配（PSM）和逆概率加权法（IPTW）来控制混杂因素。采用Cox比例风险模型评估NLR与28天、6个月和1年全因死亡率之间的关系。应用Kaplan-Meier法、亚组分析和受试者工作特征（ROC）分析来评估NLR的预后价值。
NLR的临界值为17.6。Cox比例风险模型表明，高NLR（>17.6）与28天、6个月和1年全因死亡率独立相关，风险比（HR）分别为1.58（1.29，1.94）、1.51（1.28，1.77）和1.45（1.25，1.69）。结果与生存分析一致（p<0.001，对数秩检验）。ROC分析表明，NLR的辨别能力优于其他基于血液的生物标志物。
NLR是未经选择的癌症重症患者生存的一个有前景的预后指标。
