Department of Orthopaedics, Minzu Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, China.
People's Hospital of Baise, Baise, Guangxi, China.
BMC Cancer. 2022 Jan 4;22(1):33. doi: 10.1186/s12885-021-09130-7.
At present, no predictive factor has been validated for the early efficacy of neoadjuvant chemotherapy (NACT) in osteosarcoma. The purpose of this study was to investigate the significance of the neutrophil-to-lymphocyte ratio (NLR) in predicting the response to NACT in extremity osteosarcoma.
Pathological complete response (pCR) was used to assess the efficacy of NACT. Receiver operating characteristic (ROC) curves and the Youden index (sensitivity + specificity-1) were used to determine the optimal cut-off values of the NLR. Univariate and multivariate analyses using logistic regression models were conducted to confirm the independent factors affecting the efficacy of NACT.
The optimal NLR cut-off value was 2.36 (sensitivity, 80.0%; specificity, 71.3%). Univariate analysis revealed that patients with a smaller tumour volume, lower stage, lower NLR and lower PLR were more likely to achieve pCR. Multivariate analyses confirmed that the NLR before treatment was an independent risk factor for pCR. Compared to patients with a high NLR, those with a low NLR showed a more than 2-fold higher likelihood of achieving pCR (OR 2.82, 95% CI 1.36-5.17, p = 0.02).
The NLR is a novel and effective predictive factor for the response to NACT in extremity osteosarcoma patients. Patients with a higher NLR showed a lower percentage of pCR after NACT.
目前，尚无预测骨肉瘤新辅助化疗（NACT）早期疗效的预测因子。本研究旨在探讨中性粒细胞与淋巴细胞比值（NLR）在预测四肢骨肉瘤对 NACT 反应中的意义。
采用病理完全缓解（pCR）评估 NACT 的疗效。采用受试者工作特征（ROC）曲线和 Youden 指数（灵敏度+特异性-1）确定 NLR 的最佳截断值。采用逻辑回归模型进行单因素和多因素分析，以确定影响 NACT 疗效的独立因素。
最佳 NLR 截断值为 2.36（灵敏度为 80.0%，特异性为 71.3%）。单因素分析显示，肿瘤体积较小、分期较低、NLR 和 PLR 较低的患者更有可能达到 pCR。多因素分析证实，治疗前 NLR 是 pCR 的独立危险因素。与 NLR 较高的患者相比，NLR 较低的患者达到 pCR 的可能性高出 2 倍以上（OR 2.82，95%CI 1.36-5.17，p=0.02）。
NLR 是预测四肢骨肉瘤患者对 NACT 反应的一种新的有效预测因子。NLR 较高的患者在 NACT 后 pCR 百分比较低。
