高中性粒细胞与淋巴细胞比值（NLR）是 HIV 感染合并结直肠癌患者预后不良的术前炎症生物标志物：一项回顾性研究。
Higher Neutrophil-to-Lymphocyte Ratio (NLR) Is a Preoperative Inflammation Biomarker of Poor Prognosis in HIV-Infected Patients with Colorectal Cancer: A Retrospective Study.
机构信息
Department of General Surgery, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China.
出版信息
Can J Gastroenterol Hepatol. 2023 Mar 6;2023:7966625. doi: 10.1155/2023/7966625. eCollection 2023.
BACKGROUND
The serum systemic inflammation biomarkers are known predictors of colorectal cancer (CRC) patient prognosis. However, their significance in human immunodeficiency virus (HIV)-infected patients with CRC has not been studied. To address this gap, we conducted a retrospective study to evaluate the prognostic value of preoperative systemic inflammation biomarkers in HIV-infected patients with CRC.
METHODS
The study enrolled 57 patients with colorectal cancer (CRC) and HIV who underwent surgery at the Shanghai Public Health Clinical Center between January 2015 and December 2021. Preoperative tests were conducted, and systemic inflammation biomarkers were measured. The patients were categorized into two groups using the optimal cut-off value. The Kaplan-Meier method and the log-rank test were used to determine overall survival (OS) and progression-free survival (PFS). Multivariate analysis was performed using the Cox proportional regression model. A time-dependent receiver operating characteristic (t-ROC) was used to compare the prognostic abilities of the biomarkers.
RESULTS
The study included 57 HIV-infected CRC patients, with a median age of 60 and a follow-up time ranging from 3 to 86 months. Of the patients, 49 were male and 8 were female. The cumulative three-year OS and PFS rates were 55.0% and 45.0%, respectively. The optimal cut-off value for preoperative NLR was found to be 2.8, which was significantly correlated with lower CD8+ T and CD3+ T lymphocyte counts. Multivariate Cox regression analysis revealed that a low NLR was an independent predictor of better OS and PFS (OS: HR = 0.094, 95% CI: 0.02-0.45, =0.003; PFS: HR = 0.265, 95% CI: 0.088-0.8, =0.019). The time-dependent receiver operating characteristic (t-ROC) analysis showed that NLR was a superior systemic inflammation biomarker for predicting the prognosis of HIV-infected CRC patients throughout the observation period.
CONCLUSION
The preoperative neutrophil-to-lymphocyte ratio (NLR), an easily measurable immune biomarker, may provide useful prognostic information in HIV-infected colorectal cancer (CRC) patients.
背景
血清系统炎症生物标志物是结直肠癌（CRC）患者预后的已知预测因子。然而，它们在感染人类免疫缺陷病毒（HIV）的 CRC 患者中的意义尚未得到研究。为了解决这一差距，我们进行了一项回顾性研究，以评估术前系统炎症生物标志物在 HIV 感染合并 CRC 患者中的预后价值。
方法
本研究纳入了 2015 年 1 月至 2021 年 12 月在上海市公共卫生临床中心接受手术的 57 例合并 HIV 的结直肠癌（CRC）患者。进行了术前检查，并测量了系统炎症生物标志物。使用最佳截断值将患者分为两组。采用 Kaplan-Meier 法和对数秩检验确定总生存期（OS）和无进展生存期（PFS）。使用 Cox 比例风险回归模型进行多变量分析。采用时间依赖性受试者工作特征（t-ROC）比较生物标志物的预后能力。
结果
本研究共纳入 57 例 HIV 感染合并 CRC 患者，中位年龄 60 岁，随访时间 3-86 个月。其中男性 49 例，女性 8 例。累积 3 年 OS 和 PFS 率分别为 55.0%和 45.0%。术前 NLR 的最佳截断值为 2.8，与较低的 CD8+T 和 CD3+T 淋巴细胞计数显著相关。多变量 Cox 回归分析显示，低 NLR 是 OS 和 PFS 更好的独立预测因子（OS：HR=0.094，95%CI：0.02-0.45，=0.003；PFS：HR=0.265，95%CI：0.088-0.8，=0.019）。时间依赖性受试者工作特征（t-ROC）分析显示，NLR 是预测 HIV 感染合并 CRC 患者整个观察期间预后的更好的系统炎症生物标志物。
结论
术前中性粒细胞与淋巴细胞比值（NLR）是一种易于测量的免疫生物标志物，可能为 HIV 感染合并结直肠癌（CRC）患者提供有用的预后信息。
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