中性粒细胞与淋巴细胞比值和血小板与淋巴细胞比值预测宫颈癌放化疗后的结局。

Prediction of outcomes after chemoradiotherapy for cervical cancer by neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio.

机构信息

Department of Gynecological Oncology, Jiujiang, Jiangxi Province, China.

Department of Oncology, Jiujiang, Jiangxi Province, China.

出版信息

J Obstet Gynaecol. 2024 Dec;44(1):2361858. doi: 10.1080/01443615.2024.2361858. Epub 2024 Jun 12.

DOI:10.1080/01443615.2024.2361858

PMID:38864403

Abstract

BACKGROUND

Cervical cancer ranks as the second most fatal tumour globally among females. Neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) have been widely applied to the diagnosis of cancers.

METHODS

The clinicopathologic data of 180 patients with stage IB2-IIB cervical cancer who underwent radical concurrent chemoradiotherapy from January 2018 to December 2019 were retrospectively analysed. Receiver operating characteristic (ROC) curves were plotted to analyse the optimal cut-off values of NLR and PLR for predicting the therapeutic effects of concurrent chemoradiotherapy. The associations of PLR and other clinicopathological factors with 1-year survival rates were explored through univariate analysis and multivariate Cox regression analysis, respectively.

RESULTS

NLR was significantly associated with the therapeutic effects of neoadjuvant therapy, with the optimal cut-off value of 2.89, area under the ROC curve (AUC) of 0.848 (95% confidence interval [CI]: 0.712-0.896), sensitivity of 0.892 (95% CI: 0.856-0.923) and specificity of 0.564 (95% CI: 0.512-0.592). PLR had a significant association with the therapeutic effects of neoadjuvant therapy, with the optimal cut-off value of 134.27, AUC of 0.766 (95% CI: 0.724-0.861), sensitivity of 0.874 (95% CI: 0.843-0.905) and specificity of 0.534 (95% CI: 0.512-0.556). Lymphatic metastasis ([95% CI: 1.435-5.461], [95% CI: 1.336-4.281], depth of invasion ([95% CI: 1.281-3.546], [95% CI: 1.183-3.359]) and tumour size ([95% CI: 1.129-3.451], [95% CI: 1.129-3.451]) were independent factors influencing the overall survival and disease-free survival (DFS) of patients with cervical cancer. NLR (95%CI: 1.256-4.039) and PLR (95%CI:1.281-3.546) were also independent factors affecting DFS.

CONCLUSION

NLR and PLR in the peripheral blood before treatment may predict DFS of patients with stage IB2-IIB cervical cancer.

摘要

背景

宫颈癌是女性中全球第二大致命肿瘤。中性粒细胞与淋巴细胞比值（NLR）和血小板与淋巴细胞比值（PLR）已广泛应用于癌症的诊断。

方法

回顾性分析了 2018 年 1 月至 2019 年 12 月期间 180 名接受根治性同期放化疗的 IB2-IIB 期宫颈癌患者的临床病理资料。绘制受试者工作特征（ROC）曲线以分析 NLR 和 PLR 对预测同期放化疗疗效的最佳截断值。通过单因素分析和多因素 Cox 回归分析分别探讨 PLR 与其他临床病理因素与 1 年生存率的关系。

结果

NLR 与新辅助治疗的疗效显著相关，最佳截断值为 2.89，ROC 曲线下面积（AUC）为 0.848（95%置信区间[CI]：0.712-0.896），敏感性为 0.892（95%CI：0.856-0.923），特异性为 0.564（95%CI：0.512-0.592）。PLR 与新辅助治疗的疗效显著相关，最佳截断值为 134.27，AUC 为 0.766（95%CI：0.724-0.861），敏感性为 0.874（95%CI：0.843-0.905），特异性为 0.534（95%CI：0.512-0.556）。淋巴转移（[95%CI：1.435-5.461]，[95%CI：1.336-4.281]）、浸润深度（[95%CI：1.281-3.546]，[95%CI：1.183-3.359]）和肿瘤大小（[95%CI：1.129-3.451]，[95%CI：1.129-3.451]）是影响宫颈癌患者总生存和无病生存（DFS）的独立因素。NLR（95%CI：1.256-4.039）和 PLR（95%CI：1.281-3.546）也是影响 DFS 的独立因素。