中性粒细胞与淋巴细胞比值与头颈部癌症患者严重放射性黏膜炎的相关性：一项回顾性研究。

Association of neutrophil-to-lymphocyte ratio with severe radiation-induced mucositis in pharyngeal or laryngeal cancer patients: a retrospective study.

机构信息

Department of Oral Health, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan;1-7-1 Sakamoto, Nagasaki, 852-8102, Japan.

Oral Management Center, Nagasaki University Hospital, Nagasaki, Japan.

出版信息

BMC Cancer. 2021 Sep 28;21(1):1064. doi: 10.1186/s12885-021-08793-6.

DOI:10.1186/s12885-021-08793-6

PMID:34583669

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8480102/

Abstract

BACKGROUND

The neutrophil-to-lymphocyte ratio (NLR) is a marker of systemic inflammation that informs clinical decisions regarding recurrence and overall survival in most epithelial cancers. Radiotherapy for head and neck cancer leads to mucositis in almost all patients and severe radiation-mucositis affects their quality of life (QOL). However, little is known about the NLR for severe mucositis. Therefore, this study aimed to show the association between the NLR and severe radiation-induced mucositis in hypopharyngeal or laryngeal cancer patients.

METHODS

In this retrospective study, we determined the incidence of grade 3 mucositis in 99 patients who were receiving definitive radiotherapy or chemoradiotherapy (CRT) for hypopharyngeal or laryngeal cancer. We performed univariate and multivariate logistic regression analyses to investigate the characteristics of grade 3 mucositis. Kaplan-Meier curves and log-rank tests were used to evaluate the occurrence of grade 3 mucositis between two groups with high (NLR > 5) or low (NLR < 5) systemic inflammation.

RESULTS

The incidence of grade 3 mucositis was 39%. Univariate logistic regression analysis showed that the NLR (Odd ratio [OR] = 1.09; 95% confidence interval [CI] = 1.02-1.16; p = 0.016) and smoking (OR = 1.02; 95% CI = 1.00-1.03; p = 0.048) were significantly associated with grade 3 mucositis. Multivariate logistic regression analysis showed that the NLR was independently associated with grade 3 mucositis (OR = 1.09; 95% CI = 1.01-1.17; p = 0.021). Kaplan-Meier curves also showed that patients with higher NLR (NLR > 5) prior to radiotherapy developed grade 3 mucositis more frequently than those with lower NLR during radiotherapy (p = 0.045).

CONCLUSION

This study suggests that a higher NLR is a risk factor and predictor of severe radiation-induced mucositis in hypopharyngeal or laryngeal cancer patients.

摘要

背景

中性粒细胞与淋巴细胞比值（NLR）是全身性炎症的标志物，可用于指导大多数上皮癌的复发和总生存决策。头颈部癌症的放射治疗几乎会使所有患者发生黏膜炎，如果黏膜炎严重，会影响他们的生活质量（QOL）。但是，对于严重黏膜炎的 NLR 知之甚少。因此，本研究旨在探讨下咽或喉癌患者中 NLR 与严重放射性黏膜炎之间的关系。

方法

在这项回顾性研究中，我们确定了 99 例接受下咽或喉癌根治性放疗或放化疗（CRT）的患者中 3 级黏膜炎的发生率。我们进行了单变量和多变量逻辑回归分析，以研究 3 级黏膜炎的特征。使用 Kaplan-Meier 曲线和对数秩检验评估两组 NLR 较高（NLR＞5）或较低（NLR＜5）的患者中 3 级黏膜炎的发生情况。

结果

3 级黏膜炎的发生率为 39%。单变量逻辑回归分析显示，NLR（比值比 [OR]＝1.09；95%置信区间 [CI]＝1.02-1.16；p＝0.016）和吸烟（OR＝1.02；95% CI＝1.00-1.03；p＝0.048）与 3 级黏膜炎显著相关。多变量逻辑回归分析显示，NLR 与 3 级黏膜炎独立相关（OR＝1.09；95% CI＝1.01-1.17；p＝0.021）。Kaplan-Meier 曲线还显示，放射治疗前 NLR 较高（NLR＞5）的患者在放射治疗期间发生 3 级黏膜炎的频率高于 NLR 较低的患者（p＝0.045）。