Department of Thoracic Surgery, Okayama University Hospital, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan.
Department of Diagnostic Pathology, Okayama University Hospital, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan.
Surg Today. 2021 Jan;51(1):127-135. doi: 10.1007/s00595-020-02093-5. Epub 2020 Aug 3.
Sarcomas are among the most refractory malignant tumors and often recur as pulmonary metastasis. Although the presence of a high neutrophil-to-lymphocyte ratio (NLR) has been associated with the prognosis of several malignancies, the relationship between the NLR and sarcoma with pulmonary metastasis is unclear. We investigated the impact of the NLR in patients who underwent surgical resection for metastatic lung tumors from various sarcomas.
The subjects of this retrospective study were 158 patients with metastatic lung tumors from various sarcomas, who underwent initial pulmonary metastasectomy between 2006 and 2015. We examined the clinicopathological variables, including the NLR and the characteristics of surgical procedures. Survival was estimated by the Kaplan-Meier method and prognostic factors were evaluated by multivariate analysis.
Multivariate analysis revealed significantly better survival of the group with an NLR < 2.26 immediately before the most recent pulmonary metastasectomy, in addition to such factors as the largest resected lesion being < 22 mm, a disease-free interval of > 2 years, and 3 or more pulmonary metastasectomies.
The NLR immediately before the most recent pulmonary metastasectomy is a novel independent prognostic factor, which may be helpful when considering repeated pulmonary metastasectomy.
肉瘤是最具耐药性的恶性肿瘤之一，常发生肺转移。虽然高中性粒细胞与淋巴细胞比值（NLR）与多种恶性肿瘤的预后相关，但 NLR 与肉瘤伴肺转移的关系尚不清楚。我们研究了 NLR 在接受各种肉瘤肺转移瘤手术切除的患者中的影响。
本回顾性研究的对象是 2006 年至 2015 年间接受首次肺转移瘤切除术的 158 例患有各种肉瘤肺转移瘤的患者。我们检查了临床病理变量，包括 NLR 和手术特征。通过 Kaplan-Meier 法估计生存情况，并通过多因素分析评估预后因素。
多因素分析显示，在最近一次肺转移瘤切除术之前 NLR<2.26 的患者的生存时间显著延长，此外还有其他因素，如最大切除病灶<22mm、无疾病间隔>2 年和 3 次或以上肺转移瘤切除术。
最近一次肺转移瘤切除术之前的 NLR 是一个新的独立预后因素，在考虑重复肺转移瘤切除术时可能会有所帮助。
