Kang Lihua, Liu Xiangliang, Ji Wei, Zheng Kaiwen, Li Yuguang, Song Yanqiu, He Hua, Wang Xiaomeng, Yang Tingting, Guan Meng, Zhu Ge, Gao Yangyang, Guan Yanjie, Wang Lei, Li Wei
Cancer Center, The First Hospital of Jilin University, Changchun, Jilin Province, People's Republic of China.
College of Instrumentation and Electrical Engineering, Jilin University, Changchun, Jilin Province, People's Republic of China.
J Inflamm Res. 2023 Mar 27;16:1419-1429. doi: 10.2147/JIR.S401189. eCollection 2023.
Neutrophil-to-lymphocyte ratio (NLR) is an index of systemic inflammation. This study is to clarify the role of NLR in body functional status, nutritional risk and nutritional status in the course of tumor.
A multi-center cross-sectional study of patients with various types of malignant tumors was accrued from the whole country. There were 21,457 patients with completed clinical data, biochemical indicators, physical examination, the Patient-Generated Subjective Global Assessment (PG-SGA) and Nutrition Risk Screening 2002 (NRS2002) survey. Logistic regression analysis was used to figure out the influencing factors of NLR, and four models were established to evaluate the influence of NLR on body functions, nutritional risks and nutritional status.
Male patients, TNM stage IV, total bilirubin, hypertension and coronary atherosclerotic heart disease (CAHD) were independent predictors of NLR >2.5. BMI, digestive systemic tumors and triglyceride negatively affect NLR in multivariable logistic regression. NLR was an independent predictor of Karnofsky Performance Scale (KPS), fat store deficit in all degrees, moderate and severe muscle deficit, mild fluid retention and PG-SGA grade.
Male patients and those with hypertension and CAHD are prone to systemic inflammation. Systemic inflammation significantly degrades body function status and nutritional status, increases nutritional risk and influences fat and muscle metabolism in patients with malignant tumor. Improving the intervenable indicators such as elevating albumin and pre-albumin, decreasing total bilirubin and enhancing nutrition support are imperative. Obesity and triglyceride behave like anti-systemic inflammation, which is misleading due to reverse causation in the course of malignancy.
中性粒细胞与淋巴细胞比值（NLR）是全身炎症的一个指标。本研究旨在阐明NLR在肿瘤病程中对身体功能状态、营养风险和营养状况的作用。
从全国范围内收集各类恶性肿瘤患者的多中心横断面研究数据。共有21457例患者完成了临床资料、生化指标、体格检查、患者主观整体评定法（PG-SGA）和营养风险筛查2002（NRS2002）调查。采用逻辑回归分析确定NLR的影响因素，并建立四个模型来评估NLR对身体功能、营养风险和营养状况的影响。
男性患者、TNM分期IV期、总胆红素、高血压和冠状动脉粥样硬化性心脏病（CAHD）是NLR>2.5的独立预测因素。在多变量逻辑回归中，BMI、消化系统肿瘤和甘油三酯对NLR有负面影响。NLR是卡氏功能状态评分（KPS）、所有程度的脂肪储备不足、中度和重度肌肉不足、轻度液体潴留和PG-SGA分级的独立预测因素。
男性患者以及患有高血压和CAHD的患者容易发生全身炎症。全身炎症显著降低恶性肿瘤患者的身体功能状态和营养状况，增加营养风险，并影响脂肪和肌肉代谢。改善可干预指标，如提高白蛋白和前白蛋白水平、降低总胆红素并加强营养支持势在必行。肥胖和甘油三酯表现出抗全身炎症的作用，这在恶性肿瘤病程中由于因果倒置而具有误导性。
