中性粒细胞与淋巴细胞比值、单核细胞与淋巴细胞比值和血小板与淋巴细胞比值是非小细胞肺癌袖状肺叶切除术的不良预后变量。
NLR, MLR, and PLR are adverse prognostic variables for sleeve lobectomy within non-small cell lung cancer.
机构信息
Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Department of Thoracic Surgery, Shandong Public Health Clinical Center, Shandong University, Shandong, China.
出版信息
Thorac Cancer. 2024 Aug;15(24):1792-1804. doi: 10.1111/1759-7714.15405. Epub 2024 Jul 21.
BACKGROUND
The goal of the research was to examine the value of peripheral blood indicators in forecasting survival and recurrence among people suffering central-type non-small cell lung cancer (NSCLC) undergoing sleeve lobectomy (SL).
METHODS
Clinical information was gathered from 146 individuals suffering from NSCLC who had SL at our facility between January 2014 and May 2023. Peripheral blood neutrophil lymphocyte ratio (NLR), monocyte lymphocyte ratio (MLR), and platelet lymphocyte ratio (PLR) levels were determined by receiver operating characteristic (ROC) curve to establish the threshold points. Kaplan-Meier survival analysis was employed to evaluate the prognostic value of different groupings, and both univariate and multivariate Cox proportional hazards model (referred to as COX) were performed.
RESULTS
The disease-free survival (DFS) and overall survival (OS) cutoff values were carried out via ROC analysis. Kaplan-Meier survival analysis revealed notable differences in OS for NLR (≥2.196 vs. <2.196, p = 0.0009), MLR (≥0.2763 vs. <0.2763, p = 0.0018), and PLR (≥126.11 vs. <126.11, p = 0.0354). Similarly, significant differences in DFS were observed for NLR (≥3.010 vs. <3.010, p = 0.0005), MLR (≥0.2708 vs. <0.2708, p = 0.0046), and PLR (≥126.11 vs. <126.11, p = 0.0028). Univariate Cox analysis showed that NLR (hazard ratio [HR]: 2.469; 95% confidence interval [CI]: 1.416-4.306, p < 0.001), MLR (HR: 2.192, 95% CI: 1.319-3.643, p = 0.002) and PLR (HR: 1.696, 95% CI: 1.029-2.795, p = 0.038) were correlated alongside OS. Multivariate Cox analysis showed that NLR (HR: 2.036, 95% CI: 1.072-3.864, p = 0.030) was a separate OS risk variable. Additionally, the pN stage (HR: 3.163, 95% CI: 1.660-6.027, p < 0.001), NLR (HR: 2.530, 95% CI: 1.468-4.360, p < 0.001), MLR (HR: 2.229, 95% CI: 1.260-3.944, p = 0.006) and PLR (HR: 2.249, 95% CI: 1.300-3.889, p = 0.004) were connected to DFS. Multivariate Cox analysis showed that pN stage (HR: 3.098, 95% CI: 1.619-5.928, p < 0.001) was a separate DFS risk variable.
CONCLUSION
The study demonstrates that NLR, MLR, and PLR play a convenient and cost-effective role in predicting survival and recurrence among individuals alongside central-type NSCLC having SL.
背景
本研究旨在探讨外周血指标在预测接受袖状肺叶切除术（SL）的中央型非小细胞肺癌（NSCLC）患者生存和复发中的价值。
方法
收集了 2014 年 1 月至 2023 年 5 月在我院接受 SL 的 146 例 NSCLC 患者的临床资料。通过接受者操作特征（ROC）曲线确定外周血中性粒细胞与淋巴细胞比值（NLR）、单核细胞与淋巴细胞比值（MLR）和血小板与淋巴细胞比值（PLR）的阈值点。采用 Kaplan-Meier 生存分析评估不同分组的预后价值，并进行单因素和多因素 Cox 比例风险模型（COX）分析。
结果
通过 ROC 分析得出无病生存率（DFS）和总生存率（OS）的截断值。Kaplan-Meier 生存分析显示 NLR（≥2.196 与 <2.196，p=0.0009）、MLR（≥0.2763 与 <0.2763，p=0.0018）和 PLR（≥126.11 与 <126.11，p=0.0354）的 OS 存在显著差异。同样，NLR（≥3.010 与 <3.010，p=0.0005）、MLR（≥0.2708 与 <0.2708，p=0.0046）和 PLR（≥126.11 与 <126.11，p=0.0028）的 DFS 也存在显著差异。单因素 Cox 分析显示 NLR（危险比[HR]：2.469；95%置信区间[CI]：1.416-4.306，p<0.001）、MLR（HR：2.192，95%CI：1.319-3.643，p=0.002）和 PLR（HR：1.696，95%CI：1.029-2.795，p=0.038）与 OS 相关。多因素 Cox 分析显示 NLR（HR：2.036，95%CI：1.072-3.864，p=0.030）是 OS 的独立风险因素。此外，pN 分期（HR：3.163，95%CI：1.660-6.027，p<0.001）、NLR（HR：2.530，95%CI：1.468-4.360，p<0.001）、MLR（HR：2.229，95%CI：1.260-3.944，p=0.006）和 PLR（HR：2.249，95%CI：1.300-3.889，p=0.004）与 DFS 相关。多因素 Cox 分析显示 pN 分期（HR：3.098，95%CI：1.619-5.928，p<0.001）是 DFS 的独立风险因素。
结论
本研究表明 NLR、MLR 和 PLR 在预测接受 SL 的中央型 NSCLC 患者的生存和复发方面具有方便、经济有效的作用。
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