Liang Chunyu, Xu Zhiyuan, Shen Xinping, Wu Kusheng
Department of Medical Imaging, Radiology Center, The University of Hong Kong-Shenzhen Hospital, Shenzhen 518000, China.
Department of Clinical Oncology, The University of Hong Kong-Shenzhen Hospital, Shenzhen 518000, China.
J Oncol. 2022 Mar 18;2022:3409487. doi: 10.1155/2022/3409487. eCollection 2022.
The aim of this study was to determine the correlation between neutrophil-to-lymphocyte ratio (NLR) and various tumor parameters assessed by pretreatment magnetic resonance imaging (MRI) and to evaluate their prognostic significance for cervical carcinoma treated with radiotherapy (RT).
The study enrolled 78 patients with biopsy-proven squamous cell carcinoma (SCC) of primary cervical cancer (clinically staged IB2 to IVA) who were treated in the Department of Clinical Oncology of the University of Hong Kong-Shenzhen Hospital between August 2015 and May 2019. A retrospective analysis of patients with SCC was performed. Firstly, we investigated the correlations between NLR and MRI parameters. Then, univariate and multivariate analyses were performed to identify the prognostic factors for overall survival (OS) and progression-free survival (PFS). Kaplan-Meier curves were constructed for OS and PFS.
Higher NLR showed significant association with larger tumor diameter and parametrial invasion assessed by pretreatment MRI. Univariate analysis indicated that uterine body invasion, parametrial invasion, and NLR were associated with prognosis of cervical cancer. Multivariable analyses demonstrated that parametrial invasion and NLR higher than the cutoff were independently associated with shorter OS and PFS, whereas uterine body invasion showed a significantly unfavorable influence on OS but showed no significant effect on PFS. Using the three risk factors of NLR above cutoff, parametrial invasion, and uterine body invasion, patients were divided into three subgroups. The three-year OS rates of patients with zero risk factors, one risk factor, and two or three of these factors were 96%, 91%, and 42%, respectively ( < 0.001), showing a downward trend.
Uterine body invasion, parametrial invasion, and NLR were significant prognostic factors for patients with cervical carcinoma treated with RT. These results may supplement FIGO staging to improve prognostic assessment of patients.
本研究旨在确定中性粒细胞与淋巴细胞比值（NLR）与治疗前磁共振成像（MRI）评估的各种肿瘤参数之间的相关性，并评估其对宫颈癌放疗（RT）的预后意义。
本研究纳入了78例经活检证实为原发性宫颈癌鳞状细胞癌（SCC）的患者（临床分期为IB2至IVA期），这些患者于2015年8月至2019年5月在香港大学深圳医院临床肿瘤学系接受治疗。对SCC患者进行回顾性分析。首先，我们研究了NLR与MRI参数之间的相关性。然后，进行单因素和多因素分析以确定总生存期（OS）和无进展生存期（PFS）的预后因素。构建了OS和PFS的Kaplan-Meier曲线。
较高的NLR与治疗前MRI评估的较大肿瘤直径和宫旁浸润显著相关。单因素分析表明，子宫体浸润、宫旁浸润和NLR与宫颈癌的预后相关。多因素分析表明，宫旁浸润和高于临界值的NLR与较短的OS和PFS独立相关，而子宫体浸润对OS有显著不利影响，但对PFS无显著影响。利用NLR高于临界值、宫旁浸润和子宫体浸润这三个危险因素，将患者分为三个亚组。无危险因素、有一个危险因素以及有两个或三个危险因素的患者三年OS率分别为96%、91%和42%（<0.001），呈下降趋势。
子宫体浸润、宫旁浸润和NLR是接受RT治疗的宫颈癌患者的重要预后因素。这些结果可能补充国际妇产科联盟（FIGO）分期，以改善患者的预后评估。
