Akyol Duygu, Özcan Funda Gümüş
Department of Anesthesiology and Reanimation, Başakşehir Çam and Sakura City Hospital, Republic of Turkey Ministry of Health, İstanbul, Turkey.
Medicine (Baltimore). 2025 Feb 14;104(7):e41504. doi: 10.1097/MD.0000000000041504.
In cancer patients, prognostic markers are needed to improve the management and clinical course of both the cancer itself and surgery therefor. Elevated systemic inflammatory markers are associated with morbidity and mortality in most cancer types. In this study, we aimed to determine the prognostic value of inflammatory markers such as neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), and lymphocyte to monocyte ratio (LMR) in patients undergoing cytoreductive surgery for ovarian cancer. The data of 188 patients who underwent surgery for ovarian cancer between December 2022 and December 2023 were retrospectively analyzed. Receiver operating characteristic (ROC) curves were constructed to evaluate the correlation between complications and the inflammatory prognostic factors NLR, PLR, and LMR. Optimal cutoff values were determined as the points where the Youden index (sensitivity + specificity - 1) was maximal. Patients were compared according to the presence of complications. As a result of the ROC curve analysis, patients were divided as high and low NLR and PLR groups. The difference of preoperative and postoperative inflammatory prognostic factors was compared according to the presence of complications. In this study in which a total of 90 patients were evaluated, the cutoff value for NLR was 2.04 (areas under the ROC curve: 0.655; P < .05) and the cutoff value for PLR was 145.3 (areas under the ROC curve: 0.740; P < .05) according to the presence of complications. In the group with complications, lymphopenia and thrombocytosis were more common preoperatively, while patients were more anemic postoperatively (P < .05). Patients in the high NLR group were younger and received less neoadjuvant chemotherapy. In the high PLR group, the number of patients receiving neoadjuvant chemotherapy was lower, and although the patients were more anemic and lymphopenic, higher rates of neutrophilia and thrombocytosis were observed. The analysis of preoperative and postoperative NLR, PLR, and LMR differences revealed an increase in NLR and PLR values and a decrease in LMR values (P < .05). The preoperative systemic inflammatory biomarkers NLR and PLR may be considered as prognostic predictors of poor postoperative outcomes. Therefore, consideration of these biomarkers may have an important role in clinical course management.
在癌症患者中，需要预后标志物来改善癌症本身及其手术治疗的管理和临床进程。大多数癌症类型中，全身炎症标志物升高与发病率和死亡率相关。在本研究中，我们旨在确定炎症标志物如中性粒细胞与淋巴细胞比值（NLR）、血小板与淋巴细胞比值（PLR）以及淋巴细胞与单核细胞比值（LMR）在接受卵巢癌减瘤手术患者中的预后价值。回顾性分析了2022年12月至2023年12月期间188例接受卵巢癌手术患者的数据。构建受试者工作特征（ROC）曲线以评估并发症与炎症预后因素NLR、PLR和LMR之间的相关性。将约登指数（敏感度 + 特异度 - 1）最大的点确定为最佳截断值。根据并发症的存在对患者进行比较。ROC曲线分析结果将患者分为NLR和PLR高低组。根据并发症的存在比较术前和术后炎症预后因素的差异。在本研究中，共评估了90例患者，根据并发症情况，NLR的截断值为2.04（ROC曲线下面积：0.655；P <.05），PLR的截断值为145.3（ROC曲线下面积：0.740；P <.05）。在有并发症的组中，术前淋巴细胞减少和血小板增多更常见，而术后患者贫血更严重（P <.05）。NLR高的组患者更年轻，接受新辅助化疗的次数更少。在PLR高的组中，接受新辅助化疗的患者数量较少，尽管患者贫血和淋巴细胞减少更严重，但观察到中性粒细胞增多和血小板增多的发生率更高。术前和术后NLR、PLR和LMR差异分析显示NLR和PLR值升高，LMR值降低（P <.05）。术前全身炎症生物标志物NLR和PLR可被视为术后不良结局的预后预测指标。因此，考虑这些生物标志物可能在临床进程管理中发挥重要作用。
