血浆纤维蛋白原联合中性粒细胞与淋巴细胞比值对非小细胞肺癌根治术后患者预后的分析。
Prognostic analysis of the plasma fibrinogen combined with neutrophil-to-lymphocyte ratio in patients with non-small cell lung cancer after radical resection.
机构信息
Department of Chinese Integrative Medicine Oncology, The First Affiliated Hospital of Anhui Medical University, Hefei, China.
Department of Integrated Traditional Chinese and Western Medicine, Anhui Medical University, Hefei, China.
出版信息
Thorac Cancer. 2023 May;14(15):1383-1391. doi: 10.1111/1759-7714.14883. Epub 2023 Apr 10.
BACKGROUND
To investigate the correlation between the fibrinogen combined with neutrophil-to-lymphocyte ratio (F-NLR) and the clinicopathologic features of non-small cell lung cancer (NSCLC) patients who underwent radical resection.
METHODS
This study reviewed the medical records of 289 patients with NSCLC who underwent radical resection. The patients were stratified into three groups based on F-NLR as follows: patients with low NLR and fibrinogen were group A, patients with high NLR or fibrinogen were group B, and patients with high NLR and fibrinogen were group C. Receiver operating characteristic curve and Youden index were used to determine the cutoff value of the NLR and fibrinogen. Survival curves were described by Kaplan-Meier method and compared by log-rank test. The univariate and multivariate analyses were performed with the Cox proportional hazard model to identify the prognostic factors.
RESULTS
A value of 3.19 was taken as the optimal cutoff value of NLR in this study. A value of 309 was used as the optimal cutoff value of fibrinogen. Cox multivariate analysis showed that tumor, nodes, metastasis (TNM) stage and F-NLR were independent prognostic factors affecting the survival rate of patients. The first-, third-, and fifth-year survival rates in group A were 99.2%, 96.6%, and 95.0%, respectively. The first-, third-, and fifth-year survival rates in group B were 98.4%, 76.6%, and 63.2%, respectively. The first-, third-, and fifth-year survival rates in group C were 91.3%, 41.1%, and 22.8%, respectively. F-NLR was significantly correlated with overall survival in patients with NSCLC (p < 0.001).
CONCLUSIONS
The F-NLR level is markedly related to the prognosis of patients with NSCLC undergoing radical surgery. Therefore, closer attention should be given to patients with NSCLC with a high F-NLR before surgery to provide postoperative adjuvant therapy.
背景
探讨纤维蛋白原与中性粒细胞与淋巴细胞比值（F-NLR）联合与行根治性切除术的非小细胞肺癌（NSCLC）患者临床病理特征的相关性。
方法
本研究回顾性分析了 289 例行根治性切除术的 NSCLC 患者的病历资料。根据 F-NLR 将患者分为三组：低 NLR 和纤维蛋白原组（A 组）、高 NLR 或纤维蛋白原组（B 组）和高 NLR 与纤维蛋白原组（C 组）。采用受试者工作特征曲线和 Youden 指数确定 NLR 和纤维蛋白原的截断值。采用 Kaplan-Meier 法描述生存曲线，采用对数秩检验比较。采用 Cox 比例风险模型进行单因素和多因素分析，以确定预后因素。
结果
本研究取 NLR 的最佳截断值为 3.19，纤维蛋白原的最佳截断值为 309。Cox 多因素分析显示，肿瘤、淋巴结、转移（TNM）分期和 F-NLR 是影响患者生存率的独立预后因素。A 组的 1、3、5 年生存率分别为 99.2%、96.6%和 95.0%，B 组的 1、3、5 年生存率分别为 98.4%、76.6%和 63.2%，C 组的 1、3、5 年生存率分别为 91.3%、41.1%和 22.8%。F-NLR 与 NSCLC 患者的总生存显著相关（p<0.001）。
结论
F-NLR 水平与行根治性手术的 NSCLC 患者的预后明显相关。因此，术前应更加关注 F-NLR 水平较高的 NSCLC 患者，为术后辅助治疗提供依据。
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