Ertekin Sümeyre Seda, Mangas Cristina, Riquelme-Mc Loughlin Constanza, Carrera Cristina, Malvehy Josep, Puig Susana, Podlipnik Sebastian
Department of Dermatology, Hospital Clinic of Barcelona, University of Barcelona, Barcelona, Spain; Department of Dermatology, Koç University School of Medicine, Istanbul, Turkey.
Department of Dermatology, Hospital Clinic of Barcelona, University of Barcelona, Barcelona, Spain.
Acta Derm Venereol. 2024 Apr 24;104:adv27571. doi: 10.2340/actadv.v104.27571.
The prognostic value of the neutrophil-lymphocyte ratio, platelet-lymphocyte ratio and monocyte-lymphocyte ratio in patients with melanoma has yielded controversial results in the literature. A retrospective single-centre cohort study was conducted from 1998 to 2020, including patients diagnosed with invasive melanoma. A total of 2,721 patients were included in the study. The median follow-up was 8.23 years (IQR 4.41-13.25). The median baseline neutrophil- lymphocyte ratio, platelet-lymphocyte ratio and monocyte-lymphocyte ratio values increased significantly (p < 0.001) with the increasing American Joint Committee on Cancer stage. The optimal cut-off values for neutrophil-lymphocyte ratio, platelet-lymphocyte ratio and monocyte-lymphocyte ratio were determined as 2.1, 184 and 0.2, respectively. In the multivariate analysis, high levels of neutrophil-lymphocyte ratio (≥ 2.1), platelet-lymphocyte ratio (≥ 184) and monocyte-lymphocyte ratio (≥ 0.2) were independently associated with significantly shorter melanoma-specific survival (neutrophil-lymphocyte ratio: HR 1.30, 95% CI 1.06-1.60, p = 0.013; platelet-lymphocyte ratio: HR 1.37, 95% CI 1.06-1.76, p = 0.014; monocyte- lymphocyte ratio: HR 1.29, 95% CI 1.05-1.58, p = 0.015) and overall survival (neutrophil-lymphocyte ratio: HR 1.39, 95% CI 1.19-1.64, p < 0.001; platelet- lymphocyte ratio: HR 1.44, 95% CI 1.19-1.74, p < 0.001; monocyte-lymphocyte ratio: HR 1.42, 95% CI 1.21-1.66, p < 0.001). High levels of neutrophil- lymphocyte ratio and monocyte-lymphocyte ratio were also associated with poor relapse-free survival, while platelet-lymphocyte ratio was not. In conclusion, baseline neutrophil-lymphocyte ratio, platelet-lymphocyte ratio and monocyte-lymphocyte ratio were identified as independent predictors for the prognosis of melanoma.
中性粒细胞与淋巴细胞比值、血小板与淋巴细胞比值及单核细胞与淋巴细胞比值在黑色素瘤患者中的预后价值在文献中已产生了有争议的结果。我们进行了一项回顾性单中心队列研究，时间跨度为1998年至2020年，纳入了被诊断为侵袭性黑色素瘤的患者。该研究共纳入2721例患者。中位随访时间为8.23年（四分位间距4.41 - 13.25年）。随着美国癌症联合委员会分期的增加，中性粒细胞与淋巴细胞比值、血小板与淋巴细胞比值及单核细胞与淋巴细胞比值的基线中位数值显著升高（p < 0.001）。中性粒细胞与淋巴细胞比值、血小板与淋巴细胞比值及单核细胞与淋巴细胞比值的最佳截断值分别确定为2.1、184和0.2。在多变量分析中，中性粒细胞与淋巴细胞比值（≥2.1）、血小板与淋巴细胞比值（≥184）及单核细胞与淋巴细胞比值（≥0.2）升高均与黑色素瘤特异性生存期显著缩短独立相关（中性粒细胞与淋巴细胞比值：HR 1.30，95%CI 1.06 - 1.60，p = 0.013；血小板与淋巴细胞比值：HR 1.37，95%CI 1.06 - 1.76，p = 0.014；单核细胞与淋巴细胞比值：HR 1.29，95%CI 1.05 - 1.58，p = 0.015）以及总生存期缩短独立相关（中性粒细胞与淋巴细胞比值：HR 1.39，95%CI 1.19 - 1.64，p < 0.001；血小板与淋巴细胞比值：HR 1.44，95%CI 1.19 - 1.74，p < 0.001；单核细胞与淋巴细胞比值：HR 1.42，95%CI 1.21 - 1.66，p < 0.001）。中性粒细胞与淋巴细胞比值及单核细胞与淋巴细胞比值升高也与无复发生存期较差相关，而血小板与淋巴细胞比值则不然。总之，基线中性粒细胞与淋巴细胞比值、血小板与淋巴细胞比值及单核细胞与淋巴细胞比值被确定为黑色素瘤预后的独立预测指标。
