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晚期子宫内膜癌患者中性粒细胞/淋巴细胞比值和血小板/淋巴细胞比值的预后价值分析

The analysis of the prognostic value of the neutrophil/ lymphocyte ratio and the platelet/lymphocyte ratio among advanced endometrial cancer patients.

作者信息

Muzykiewicz Konrad Piotr, Iwanska Ewa, Janeczek Maja, Glanowska Izabela, Karolewski Kaziemierz, Blecharz Pawel

机构信息

Department of Gynaecologic Oncology, Maria Sklodowska-Curie National Research Institute of Oncology, Cracow Branch, Poland, Poland.

Department of Gynaecology and Obstetrics, Stefan Zeromski Memorial Specialist City Hospital, Cracow, Poland.

出版信息

Ginekol Pol. 2021;92(1):16-23. doi: 10.5603/GP.a2020.0164. Epub 2021 Jan 15.

Abstract

OBJECTIVES

About 20% of endometrial cancer (EC) patients have advanced disease (FIGO III & IV) at the moment of diagnosis. An attempt to evaluate the prognostic value of biochemical markers of inflammation and classic endometrial cancer prognostic factors in the group of advanced EC (aEC) patients has been made in this study.

MATERIAL AND METHODS

Records of 266 patients treated in the Maria Sklodowska-Curie Memorial Cancer Centre and Institute of Oncology, Cracow Branch between the year 2006 and 2018 were included in the study. Follow-up ranged from 1 to 138 months. Progression free survival (PFS) and overall survival (OS) have been set as endpoints. Tests such as: chi-squared, Fisher, log-rank, Mann-Whitney, Kruskal-Wallis and Cox proportional hazard ratio were used in the statistical analyses.

RESULTS

In the analysed group high total platelet count (PLT) before operative treatment and high levels of white blood cells (WBC), PLT, neutrophil/lymphocyte ratio (NLR) and platelet/lymphocyte ratio (PLR) before adjuvant therapy (AT) have been significantly associated with shorter PFS and OS. After setting the cut-off values of NLR and PLR a statistically significant correlation between those parameters and PFS as well as OS has been shown. Multivariate analysis has indicated that NLR is an independent prognostic factor of the course of aEC.

CONCLUSIONS

NLR and PLR correlate significantly with OS and PFS in aEC. NLR is an independent prognostic factor in this group. It is possible to distinguish 3 risk groups, among aEC patients, based on NRL and PLR.

摘要

目的

约20%的子宫内膜癌(EC)患者在确诊时已处于晚期疾病(国际妇产科联盟(FIGO)III期和IV期)。本研究试图评估晚期子宫内膜癌(aEC)患者炎症生化标志物和经典子宫内膜癌预后因素的预后价值。

材料与方法

本研究纳入了2006年至2018年期间在克拉科夫分所玛丽亚·斯克沃多夫斯卡-居里纪念癌症中心和肿瘤研究所接受治疗的266例患者的记录。随访时间为1至138个月。无进展生存期(PFS)和总生存期(OS)被设定为终点。统计分析中使用了卡方检验、费舍尔检验、对数秩检验、曼-惠特尼检验、克鲁斯卡尔-沃利斯检验和Cox比例风险比检验。

结果

在分析的组中,手术治疗前血小板总数(PLT)高以及辅助治疗(AT)前白细胞(WBC)、PLT、中性粒细胞/淋巴细胞比值(NLR)和血小板/淋巴细胞比值(PLR)高与较短的PFS和OS显著相关。在设定NLR和PLR的临界值后,这些参数与PFS以及OS之间显示出统计学上的显著相关性。多变量分析表明,NLR是aEC病程的独立预后因素。

结论

在aEC中,NLR和PLR与OS和PFS显著相关。NLR是该组的独立预后因素。基于NLR和PLR,可以在aEC患者中区分出3个风险组。

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