Dong Yangyang, Cheng Yuan, Wang Jianliu
Peking University People's Hospital, Beijing, China.
Open Life Sci. 2019 Apr 6;14:110-118. doi: 10.1515/biol-2019-0012. eCollection 2019 Jan.
The aim of our study was to assess the prognostic value of the ratio of neutrophil to lymphocyte (NLR) for patients with surgically treated endometrial cancer (EC).
We retrospectively reviewed 510 EC patients who were surgically treated between January 2010 and December 2016. We used receiver-operating characteristic (ROC) curve analysis to identify an optimal cut-off for NLR in predicting overall survival (OS), cancer-specific survival (CSS) and disease-free survival (DFS). Nonparametric tests were used to determine the associations between NLR and clinicopathologic characteristics. The Kaplan-Meier method and Cox proportional-hazards regression were used for survival analysis.
With a cut-off of 2.47, the 510 patients were divided into low NLR (NLR <2.47) and high NLR (NLR ≥2.47). Elevated NLR was associated with advanced stage (P=0.039), increased histology grade (P=0.005) and lymph node metastasis (P=0.041). Multivariable analysis suggested that NLR was an independent prognostic marker for OS (hazard ratio [HR] 4.7; 95% confidence interval [CI], 1.5-14.1; P =0.006), CSS (HR 3.6; 95% CI, 1.1-11.5; P =0.028) and DFS (HR 2.3; 95% CI, 1.0-5.2; P =0.044).
NLR may be an independent prognostic indicator for OS, CSS and DFS. It could help clinicians with preoperative risk stratification and treatment strategy tailoring.
本研究旨在评估中性粒细胞与淋巴细胞比值（NLR）对接受手术治疗的子宫内膜癌（EC）患者的预后价值。
我们回顾性分析了2010年1月至2016年12月期间接受手术治疗的510例EC患者。我们使用受试者操作特征（ROC）曲线分析来确定NLR预测总生存期（OS）、癌症特异性生存期（CSS）和无病生存期（DFS）的最佳临界值。采用非参数检验确定NLR与临床病理特征之间的关联。采用Kaplan-Meier法和Cox比例风险回归进行生存分析。
以2.47为临界值，将510例患者分为低NLR组（NLR<2.47）和高NLR组（NLR≥2.47）。NLR升高与晚期（P=0.039）、组织学分级增加（P=0.005）和淋巴结转移（P=0.041）相关。多变量分析表明，NLR是OS（风险比[HR]4.7；95%置信区间[CI]，1.5-14.1；P=0.006）、CSS（HR 3.6；95%CI，1.1-11.5；P=0.028）和DFS（HR 2.3；95%CI，1.0-5.2；P=0.044）的独立预后标志物。
NLR可能是OS、CSS和DFS的独立预后指标。它可以帮助临床医生进行术前风险分层和制定治疗策略。
