Shi Cong, Gong Shengping, Niu Tingting, Li Tongyu, Wu An, Zheng Xiaojiao, Yang Shujun, Ouyang Guifang, Mu Qitian
Stem Cell Transplantation Laboratory, Ningbo First Hospital, Ningbo, China.
Cancer Radiotherapy and Chemotherapy Center, Ningbo First Hospital, Ningbo, China.
Front Oncol. 2022 Apr 26;12:877981. doi: 10.3389/fonc.2022.877981. eCollection 2022.
Inflammation appears to have a critical role in carcinogenesis tumor growth according to emerging research. The platelet-to-lymphocyte ratio (PLR), neutrophil-to-lymphocyte ratio (NLR), and plasma C-reactive protein (CRP) are considered to reflect the systemic inflammatory response and clinical prognosis. The prognostic value of inflammatory indices in myelodysplastic syndrome (MDS) patients remains unclear.
A total of 213 MDS patients were enrolled for the study. Univariate and multivariate analyses were performed to determine the prognostic significance of various indicators, including PLR, NLR, and CRP.
MDS patients with higher PLR, NLR, and CRP levels had significantly shorter overall survival (OS). Based on univariate analysis, age (≥60 years), gender (men), lower hemoglobin level (<10 g/dl), higher bone marrow blast percentage (>5%), poorer karyotype, and higher Revised International Prognostic Scoring System (IPSS-R) score were significantly associated with shorter OS. Patients with higher CRP levels had shorter leukemia-free survival (LFS, = 0.041). However, higher PLR and NLR had no significant influence on LFS ( > 0.05). Multivariate Cox proportional hazards regression analysis indicated that high PLR and CRP were also independent adverse prognostic factors for OS in MDS.
Elevated PLR and CRP predict poor prognosis independent of the IPSS-R and provide a novel evaluation factor for MDS patients.
根据最新研究，炎症在癌症发生和肿瘤生长中似乎起着关键作用。血小板与淋巴细胞比值（PLR）、中性粒细胞与淋巴细胞比值（NLR）以及血浆C反应蛋白（CRP）被认为可反映全身炎症反应和临床预后。炎症指标在骨髓增生异常综合征（MDS）患者中的预后价值仍不清楚。
共纳入213例MDS患者进行研究。进行单因素和多因素分析以确定包括PLR、NLR和CRP在内的各种指标的预后意义。
PLR、NLR和CRP水平较高的MDS患者总生存期（OS）明显较短。基于单因素分析，年龄（≥60岁）、性别（男性）、血红蛋白水平较低（<10 g/dl）、骨髓原始细胞百分比更高（>5%）、核型较差以及修订的国际预后评分系统（IPSS-R）得分较高与较短的OS显著相关。CRP水平较高的患者无白血病生存期（LFS）较短（P = 0.041）。然而，较高的PLR和NLR对LFS无显著影响（P>0.05）。多因素Cox比例风险回归分析表明，高PLR和CRP也是MDS患者OS的独立不良预后因素。
PLR和CRP升高独立于IPSS-R预示预后不良，并为MDS患者提供了一个新的评估因素。
