Weng Jinsen, Huang Jieping, Yu Wei, Zhao Zhiyong, Zhu Biao, Lin Jingping, Cai Yibin, Zhang Jiulong, Su Weikun, Chen Xiaohui, Zhu Kunshou, Lin Shaofeng
Department of Critical Care Medicine, Fujian Medical University Cancer Hospital & Fujian Cancer Hospital, Fuzhou, China.
Emergency Department of Fujian Medical University Union Hospital, Fuzhou, China.
J Thorac Dis. 2021 Sep;13(9):5508-5516. doi: 10.21037/jtd-21-1320.
Lung cancer contributes significantly to the total of cancer-linked deaths globally, accounting for 1.3 million deaths each year. Preoperative albumin (Alb) concentration and neutrophil-to-lymphocyte ratio (NLR) may reflect chronic inflammation and be used to predict lung cancer outcomes.
The clinical records of 293 patients with non-small cell lung cancer (NSCLC) in Fujian Medical University Cancer Hospital & Fujian Cancer Hospital were reviewed retrospectively in this current study. Clinicopathologic pretreatment, including NLR, Glasgow prognostic score (GPS), and post-treatment value, such as tumor-node-metastasis (TNM) were documented. The cut-off finder application was employed to calculate the optimal threshold values. The significance of Alb concentration combined with NLR (COA-NLR) on the prediction of overall survival (OS) was explored using Kaplan-Meier analysis along with Cox proportional hazards.
The results revealed that COA-NLR could independently assess the OS of patients with NSCLC [hazard ratio (HR) =1.952, 95% confidence interval (CI): 1.367 to 2.647, P<0.001]. Moreover, the 3-year OS rates were 87.2%, 68.5%, and 52.8% for the COA-NLR =0, COA-NLR =1, and COA-NLR =2, respectively (P<0.001).
Preoperative COA-NLR value can effectively stratifies prognosis in NSCLC patients by classified patients into three independent groups. It can be adopted as an effective biomarker for prognosis in NSCLC patients treated with resection.
肺癌在全球癌症相关死亡总数中占比重大,每年导致130万人死亡。术前白蛋白(Alb)浓度和中性粒细胞与淋巴细胞比值(NLR)可能反映慢性炎症,并可用于预测肺癌预后。
本研究回顾性分析了福建医科大学附属肿瘤医院和福建省肿瘤医院293例非小细胞肺癌(NSCLC)患者的临床记录。记录了包括NLR、格拉斯哥预后评分(GPS)等临床病理预处理情况以及肿瘤-淋巴结-转移(TNM)等治疗后情况。采用截断值查找应用程序计算最佳阈值。使用Kaplan-Meier分析和Cox比例风险模型探讨Alb浓度联合NLR(COA-NLR)对总生存期(OS)预测的意义。
结果显示,COA-NLR可独立评估NSCLC患者的OS[风险比(HR)=1.952,95%置信区间(CI):1.367至2.647,P<0.001]。此外,COA-NLR =0、COA-NLR =1和COA-NLR =2时的3年OS率分别为87.2%、68.5%和52.8%(P<0.001)。
术前COA-NLR值可通过将NSCLC患者分为三个独立组有效地对其预后进行分层。它可作为接受手术治疗的NSCLC患者预后的有效生物标志物。