Sim Ji-Hoon, Lee Ju-Seung, Jang Dong-Min, Kim Hwa Jung, Lee Shin-Wha, Cho Hyun-Seok, Choi Woo-Jong
Asan Medical Center, Department of Anesthesiology and Pain Medicine, University of Ulsan College of Medicine, Seoul 05505, Korea.
Asan Medical Center, Department of Clinical Epidemiology and Biostatistics, University of Ulsan College of Medicine, Seoul 05505, Korea.
J Clin Med. 2021 Sep 16;10(18):4198. doi: 10.3390/jcm10184198.
There are few studies between postoperative neutrophil to lymphocyte ratio (NLR) and survival in cervical cancer. We compared postoperative changes in NLR according to surgical methods and analyzed the effect of these changes on 5-year mortality of cervical cancer patients. A total of 929 patients were assigned to either the laparoscopic radical hysterectomy (LRH) ( = 721) or open radical hysterectomy (ORH) ( = 208) group. Propensity score matching analysis compared the postoperative NLR changes between the two groups, and multivariate logistic regression analysis evaluated the association between NLR changes and 5-year mortality. Surgical outcomes between the two groups were also compared. In the LRH group, NLR changes at postoperative day (POD) 0 and POD 1 were significantly lower than in the ORH group after matching (NLR change at POD 0, 10.4 vs. 14.3, < 0.001; NLR change at POD 1, 3.5 vs. 5.4, < 0.001). In multivariate logistic regression analysis, postoperative NLR change was not associated with 5-year mortality (2nd quartile: OR 1.55, 95% CI 0.56-4.29, = 0.401; 3rd quartile: OR 0.90, 95% CI 0.29-2.82, = 0.869; 4th quartile: OR 1.40, 95% CI 0.48-3.61, = 0.598), whereas preoperative NLR was associated with 5-year mortality (OR 1.23, 95% CI 1.06-1.43, = 0.005). After matching, there were no significant differences in surgical outcomes between the two groups. There were significantly fewer postoperative changes of NLR in the LRH group. However, the extent of these NLR changes was not associated with 5-year mortality. By contrast, preoperative NLR was associated with 5-year mortality.
关于宫颈癌术后中性粒细胞与淋巴细胞比值（NLR）和生存率的研究较少。我们根据手术方式比较了术后NLR的变化，并分析了这些变化对宫颈癌患者5年死亡率的影响。总共929例患者被分为腹腔镜根治性子宫切除术（LRH）组（n = 721）或开放性根治性子宫切除术（ORH）组（n = 208）。倾向评分匹配分析比较了两组术后NLR的变化，多因素逻辑回归分析评估了NLR变化与5年死亡率之间的关联。还比较了两组的手术结果。在LRH组中，匹配后术后第0天（POD 0）和第1天（POD 1）的NLR变化显著低于ORH组（POD 0时NLR变化：10.4对14.3，P < 0.001；POD 1时NLR变化：3.5对5.4，P < 0.001）。在多因素逻辑回归分析中，术后NLR变化与5年死亡率无关（第二四分位数：OR 1.55，95%CI 0.56 - 4.29，P = 0.401；第三四分位数：OR 0.90，95%CI 0.29 - 2.82，P = 0.869；第四四分位数：OR 1.40，95%CI 0.48 - 3.61，P = 0.598），而术前NLR与5年死亡率相关（OR 1.23，95%CI 1.06 - 1.43，P = 0.005）。匹配后，两组手术结果无显著差异。LRH组术后NLR变化明显较少。然而，这些NLR变化的程度与5年死亡率无关。相比之下，术前NLR与5年死亡率相关。
