血小板与淋巴细胞比值和纤维蛋白原的联合检测可能预测接受手术治疗的非小细胞肺癌患者的5年总生存率。
Combination of the platelet-to-lymphocyte ratio and fibrinogen may predict 5-year overall survival of patient in non-small cell lung cancer treated with surgery.
作者信息
Luo Yiping, Lin Kangni, Zhang Mingji, Goto Taichiro, Brueckl Wolfgang M, Lin Jingping, Liu Xinwei, Weng Jinsen, Ye Yong
机构信息
Department of Anesthesiology, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou, China.
Department of Critical Care Medicine, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou, China.
出版信息
J Thorac Dis. 2023 Dec 30;15(12):6967-6975. doi: 10.21037/jtd-23-1730. Epub 2023 Dec 26.
BACKGROUND
Non-small cell lung cancer (NSCLC) is a major type of lung cancer with high incidence and mortality. Systemic inflammatory response (SIR) and an imbalance of the coagulation system are both associated with the tumor progression. However, few studies have investigated the prognostic utility of a combination of inflammation and the coagulation system in NSCLC. The combination of platelet-to-lymphocyte ratio (PLR) and fibrinogen (FIB) (PLR-FIB; defined as PLR × FIB) is an indicator reflecting SIR and coagulation concurrently, which have potentiality to predict prognosis of NSCLC.
METHODS
This retrospective, single-center study included 314 NSCLC patients with surgery. According to a cutoff value for the PLR-FIB, we divided participants into a low-PLR-FIB group and a high-PLR-FIB group. We retrospectively collected the data on 314 patients and used univariate and multivariate analyses to investigate the relationship between the PLR-FIB and survival.
RESULTS
Univariate analysis showed that adenosquamous carcinoma (ASC) (P=0.002), high PLR-FIB (P=0.023), and tumor-node-metastasis (TNM) stage III-IV (P<0.001) were associated with a poor outcome. On multivariate analysis, low PLR-FIB [hazard ratio (HR), 0.587; 95% confidence interval (CI): 0.359-0.985; P=0.044], and TNM stage I-II (HR, 0.380; 95% CI: 0.245-0.590; P<0.001) were independent factors of a better prognosis. ASC type was an independent prognostic factor of poor outcome (HR, 5.513; 95% CI: 1.895-16.034; P=0.002). There were no significant differences in patient demographics or clinical characteristics between the two PLR-FIB groups (P>0.05). The 5-year overall survival (OS) rates were 80.8% and 67.9% for the low-PLR-FIB group and high-PLR-FIB group, respectively (P=0.02).
CONCLUSIONS
Preoperative PLR-FIB was found to be an independent prognostic factor for 5-year overall survival in patients with NSCLC treated with surgery.
背景
非小细胞肺癌（NSCLC）是肺癌的主要类型，发病率和死亡率都很高。全身炎症反应（SIR）和凝血系统失衡均与肿瘤进展相关。然而，很少有研究探讨炎症与凝血系统联合指标在NSCLC中的预后价值。血小板与淋巴细胞比值（PLR）和纤维蛋白原（FIB）的联合指标（PLR-FIB；定义为PLR×FIB）是一个能同时反映SIR和凝血功能的指标，具有预测NSCLC预后的潜力。
方法
这项回顾性单中心研究纳入了314例接受手术的NSCLC患者。根据PLR-FIB的临界值，将参与者分为低PLR-FIB组和高PLR-FIB组。我们回顾性收集了314例患者的数据，并采用单因素和多因素分析来研究PLR-FIB与生存之间的关系。
结果
单因素分析显示，腺鳞癌（ASC）（P=0.002）、高PLR-FIB（P=0.023）和肿瘤-淋巴结-转移（TNM）Ⅲ-Ⅳ期（P<0.001）与不良预后相关。多因素分析显示，低PLR-FIB[风险比（HR），0.587；95%置信区间（CI）：0.359-0.985；P=0.044]和TNMⅠ-Ⅱ期（HR，0.380；95%CI：0.245-0.590；P<0.001）是预后较好的独立因素。ASC类型是预后不良的独立危险因素（HR，5.513；95%CI：1.895-16.034；P=0.002）。两个PLR-FIB组在患者人口统计学或临床特征方面无显著差异（P>0.05）。低PLR-FIB组和高PLR-FIB组的5年总生存率（OS）分别为80.8%和67.9%（P=0.02）。
结论
术前PLR-FIB是接受手术治疗的NSCLC患者5年总生存的独立预后因素。
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