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血红蛋白、白蛋白、淋巴细胞及血小板(HALP)评分和淋巴细胞与单核细胞比值(LMR)对非小细胞肺癌患者根治性肺癌手术后的预测价值。

Predictive value of the hemoglobin, albumin, lymphocyte, and platelet (HALP) score and lymphocyte-to-monocyte ratio (LMR) in patients with non-small cell lung cancer after radical lung cancer surgery.

作者信息

Zhai Baoqian, Chen Jia, Wu Jiacheng, Yang Lei, Guo Xiaoli, Shao Jingjing, Xu Hong, Shen Aiguo

机构信息

Department of Oncology, Nantong University, Nantong, China.

Cancer Research Center Nantong, The Affiliated Tumor Hospital of Nantong University, Nantong University, Nantong, China.

出版信息

Ann Transl Med. 2021 Jun;9(12):976. doi: 10.21037/atm-21-2120.

Abstract

BACKGROUND

Examining the analytical worth of the preoperative hemoglobin, albumin, lymphocyte, platelet (HALP) score and lymphocyte-to-monocyte ratio (LMR) within diseased persons having non-small cell lung cancer (NSCLC) after radical lung cancer surgery.

METHODS

Clinical data concerning 238 diseased persons with NSCLC who underwent radical lung cancer resection within Nantong Cancer Hospital between January 2009 and October 2015 had been looking back studied. ROC curve had been employed in regulating optimal critical worth of HALP and LMR that had been 48.00 and 6.30 singly. A 5-year amplification observed survival concerning diseased persons, and clinicopathological stuff assessed using statistics procedure. Kaplan Meier method, log rank test had been exploited from the point of view to analyze for surviving, and Cox regression analysis had been exploited for univariate and multivariate analysis. Eventually, a nomogram had been produced to examine the confirmation internally.

RESULTS

Kaplan Meier survival assessment revealed top HALP class's overall survival (OS) was significantly higher than below HALP class's (P<0.001), and high LMR group's OS was also greater than below LMR class's (P=0.001). Patients possessing average continuance period of 4 years. Further stratified study revealed high HALP class possessed notable OS as compared below HALP class (P=0.0002), and top LMR class possessed considerable OS as compared to below LMR class (P=0.003) in lung adenocarcinoma. In non-adenocarcinoma, there was no substantial difference in OS between two classes (P>0.05). Preoperative HALP and LMR remained independent risk constituents for tumor progression (P=0.005, P=0.028), lymph node metastasis and level of differentiation also had a certain effect on tumor progression (P<0.05), according to Cox multivariate analysis. Rise in HALP and LMR will help diseased persons having NSCLC live longer. The nomogram's c-index in inside validation was 0.672 (95% confidence interval: 0.626-0.718).

CONCLUSIONS

Preoperative HALP versus LMR are independent predictive aspect within NSCLC diseased persons linked to clinicopathological features, and has a particular value in determining bodement.

摘要

背景

研究术前血红蛋白、白蛋白、淋巴细胞、血小板(HALP)评分及淋巴细胞与单核细胞比值(LMR)在非小细胞肺癌(NSCLC)患者行根治性肺癌手术后的分析价值。

方法

回顾性研究2009年1月至2015年10月在南通肿瘤医院接受根治性肺癌切除术的238例NSCLC患者的临床资料。采用ROC曲线确定HALP和LMR的最佳临界值,分别为48.00和6.30。观察患者5年生存率,并采用统计学方法评估临床病理资料。采用Kaplan-Meier法、对数秩检验进行生存分析,采用Cox回归分析进行单因素和多因素分析。最终绘制列线图并进行内部验证。

结果

Kaplan-Meier生存评估显示,HALP评分高分组的总生存期(OS)显著高于HALP评分低分组(P<0.001),LMR高分组的OS也高于LMR低分组(P=0.001)。患者平均生存期为4年。进一步分层研究显示,在肺腺癌中,HALP评分高分组的OS显著高于HALP评分低分组(P=0.0002),LMR高分组的OS显著高于LMR低分组(P=0.003)。在非腺癌中,两组间OS无显著差异(P>0.05)。根据Cox多因素分析,术前HALP和LMR是肿瘤进展的独立危险因素(P=0.005,P=0.028),淋巴结转移和分化程度对肿瘤进展也有一定影响(P<0.05)。HALP和LMR升高有助于NSCLC患者延长生存期。列线图内部验证的c指数为0.672(95%置信区间:0.626-0.718)。

结论

术前HALP和LMR是NSCLC患者与临床病理特征相关的独立预测因素,在判断预后方面具有重要价值。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d993/8267290/b02ff57a4cf6/atm-09-12-976-f1.jpg

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