Londero Francesco, Grossi William, Parise Orlando, Cinel Jacqueline, Parise Gianmarco, Masullo Gianluca, Tetta Cecilia, Micali Linda Renata, Mauro Emanuela, Morelli Angelo, Maessen Jos G, Gelsomino Sandro
Cardiothoracic Department, Azienda Sanitaria Universitaria Integrata, 33100 Udine, Italy.
Cardiovascular Research Institute, Maastricht University, 6229 ER Maastricht, The Netherlands.
J Clin Med. 2020 Oct 21;9(10):3378. doi: 10.3390/jcm9103378.
The aim of this study was to assess the prognostic value of preoperative neutrophil-to-lymphocyte ratio (NLR) and C-reactive protein (CRP) levels in patients undergoing resection of pulmonary oligometastases. A retrospective analysis on 141 patients undergoing a first pulmonary metastasectomy in a single center was carried out. Two distinct analysis were performed subdividing patients according to their NLR ratio and CRP level. The main outcomes were survival and time to recurrence. At completion of follow-up 74 patients were still alive (52.5%). Subdividing patients according to their NLR yielded a significant difference in five-year progression-free survival (PFS, NLR < 4:32% vs. NLR ≥ 4:18%, = 0.01). When subdivided by their CRP levels, patients with preoperative CRP < 5 mg/L demonstrated higher values of five-year overall survival (OS, 57% vs. 34%, = 0.006) and five-year PFS (35% vs. 22%, = 0.04). At multivariate analysis, level of neutrophils ( = 0.009) and lung comorbidities ( = 0.021) were independent predictors of death, whereas preoperative CRP ( = 0.002), multiple metastases ( = 0.003) and presence of lung comorbidities ( = 0.001) were independent predictors of recurrence. NLR and CRP are important predictors of prognostic outcome in patients undergoing pulmonary metastasectomy.
本研究旨在评估术前中性粒细胞与淋巴细胞比值（NLR）和C反应蛋白（CRP）水平对接受肺寡转移灶切除术患者的预后价值。对在单一中心接受首次肺转移瘤切除术的141例患者进行了回顾性分析。根据患者的NLR比值和CRP水平进行了两项不同的分析。主要结局为生存率和复发时间。随访结束时，74例患者仍存活（52.5%）。根据NLR对患者进行细分，五年无进展生存期（PFS）存在显著差异（NLR < 4：32% vs. NLR≥4：18%，P = 0.01）。按CRP水平细分时，术前CRP < 5 mg/L的患者五年总生存期（OS，57% vs. 34%，P = 0.006）和五年PFS（35% vs. 22%，P = 0.04）更高。在多变量分析中，中性粒细胞水平（P = 0.009）和肺部合并症（P = 0.021）是死亡的独立预测因素，而术前CRP（P = 0.002）、多发转移（P = 0.003）和肺部合并症的存在（P = 0.001）是复发的独立预测因素。NLR和CRP是接受肺转移瘤切除术患者预后结局的重要预测因素。
