治疗前中性粒细胞与淋巴细胞比值在亚洲口咽鳞癌患者队列中的预后作用。

The Prognostic Role of Pre-Treatment Neutrophil-to-Lymphocyte Ratio in an Asian Cohort of Patients with Oropharyngeal Squamous Cell Carcinoma.

机构信息

Department of Otorhinolaryngology-Head and Neck Surgery, Singapore General Hospital, Outram Road, Singapore 169608, Singapore.

Health Services Research Unit, Singapore General Hospital, Outram Road, Singapore 169608, Singapore.

出版信息

Curr Oncol. 2024 Nov 12;31(11):7074-7087. doi: 10.3390/curroncol31110521.

DOI:10.3390/curroncol31110521

PMID:39590152

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11592546/

Abstract

PURPOSE

The neutrophil-to-lymphocyte ratio is a simple biomarker that reflects the balance between the systemic inflammatory and immunity status. Here we investigate the prognostic role of pre-treatment neutrophil-to-lymphocyte ratio (NLR) in an Asian cohort of oropharyngeal squamous cell carcinoma (OPSCC) patients.

METHODS

A retrospective review of OPSCC patients from a tertiary institution was conducted. The NLR was calculated from the haematological specimen taken within a month before treatment. Survival rates were estimated via the Kaplan-Meier method, and Cox proportional hazards regression was performed for univariable and multivariable analyses. The NLR cutpoint was determined using maximally selected log-rank statistics.

RESULTS

In a cohort of 148 OPSCC patients, 43% were p16-positive and 44% were p16-negative, with a median follow-up of 24 months. The p16-positive patients were younger (median age 62 vs. 67 years) and exhibited a lower prevalence of heavy smoking (47% vs. 69%). The p16-negative cases frequently presented at an advanced disease stage (74% vs. 41%), with a history of previous radiotherapy (26% vs. 3%). The p16-negative patients displayed a higher median NLR (2.91 vs. 2.49). The 3-year disease-specific survival (DSS) in p16-positive was higher compared to p16-negative patients (89.9% vs. 41.6%). The optimal NLR cutpoint was determined as 3.56 and predicted for decreased DSS (hazard ratio [HR] 2.59, = 0.004). Multivariable analysis revealed smoking, high NLR ≥ 3.56, and p16-negativity as independent variables associated with poorer DSS and overall survival (OS) across the cohort.

CONCLUSION

A high NLR is independently prognostic of poorer DSS in OPSCC, independent of p16 and smoking status. A NLR of more than 3.56 was highly prognostic for poorer survival and warrants further validation in larger cohorts of OPSCC.

摘要

目的

中性粒细胞与淋巴细胞比值（NLR）是一种简单的生物标志物，反映了全身炎症与免疫状态之间的平衡。本研究旨在探讨 NLR 在亚洲口咽鳞状细胞癌（OPSCC）患者中的预后价值。

方法

对一家三级医疗机构的 OPSCC 患者进行回顾性分析。NLR 是根据治疗前 1 个月内的血液学标本计算得出的。通过 Kaplan-Meier 法估计生存率，并进行单变量和多变量 Cox 比例风险回归分析。使用最大选择对数秩检验确定 NLR 截断值。

结果

在 148 例 OPSCC 患者中，43%为 p16 阳性，44%为 p16 阴性，中位随访时间为 24 个月。p16 阳性患者年龄较小（中位年龄 62 岁 vs. 67 岁），重度吸烟的比例较低（47% vs. 69%）。p16 阴性病例常处于晚期疾病阶段（74% vs. 41%），且有既往放疗史（26% vs. 3%）。p16 阴性患者的 NLR 中位数较高（2.91 vs. 2.49）。p16 阳性患者的 3 年疾病特异性生存率（DSS）高于 p16 阴性患者（89.9% vs. 41.6%）。最佳 NLR 截断值为 3.56，可预测 DSS 降低（风险比[HR] 2.59， = 0.004）。多变量分析显示，吸烟、高 NLR（≥3.56）和 p16 阴性是与整个队列 DSS 和总生存（OS）较差相关的独立变量。