摘要
目的探讨治疗前外周血中性粒细胞与淋巴细胞比值（NLR）与IB2-IIB期宫颈癌新辅助化疗疗效及预后的相关性。方法回顾性分析2010年1月至12月我科收治的75例行新辅助化疗联合根治性手术的ⅠB2-ⅡB期宫颈癌患者的临床病理资料,绘制受试者工作特征曲线（ROC）,分析NLR预测新辅助化疗疗效的最佳临界值。建立Logistic回归模型分析影响新辅助化疗疗效的独立相关因素,采用单因素及Cox回归模型分析NLR及其他临床病理参数对患者预后的影响。结果 NLR与新辅助化疗的疗效显著相关,预测新辅助化疗疗效的NLR最佳临界值为2.0,敏感度和特异度分别为0.556、0.731。NLR〉2.0患者的3年生存率和3年无瘤生存期均显著低于NLR≤2.0患者（P2.0患者可能预后不良。
Objective To evaluate the predictive value of pretreatment neutrophil-to-lymphocyte ratios before neoadjuvant therapy in patients with ⅠB2- ⅡB cervical cancer. Methods Between January to December 2012,a total of 75 patients with stage ⅠB2- ⅡB Cervical Cancer,who were treated with neoadjuvant therapy followed by radical surgery,were investigated. A receiver operating characteristic curve（ ROC curve） was used to determine the best NLR cut-off value in predicting response to neoadjuvant therapy. The relationships between pretreatment variables and response to neoadjuvant therapy were assessed in univariate and multivariate settings. Kaplan-Meier and Cox proportional hazards models were used for survival analysis. Results The response of neoadjvant therapy was associated with neutrophil-lymphocyte ratio（ P 〈 0. 05）. Multivariate analysis showed that lower NLR independented predicted well response of neoadjuvant therapy. At a threshold of 2. 0,the NLR was 55. 6% sensitive and 73. 1% specific. By log-rank test,overall survival and progression-free survival were significantly different between patients with high and low neutrophil-to-lymphocyte ratio（ P 〈0. 05）. On multivariate analysis,NLR was not independent prognostic variables of cervical cancer treated with neoadjuvant therapy followed by radical surgery. Conclusion As an easily measured,reproducible,and in expensive marker of systemic inflammation,pretreatment NLR showed a prognostic and independent predietive value for response to neoadjuvant chemotherapy in ⅠB2- ⅡB cervical cancer. In our preliminary report,preformed on a limited sample,a threshold of 2. 0 for NLR seems to be helpful to distinguish between＂optimal＂and＂non-optimal＂response,and teem to be the prognostic factors for cervical cancer.
出处
《临床军医杂志》
CAS
2016年第2期119-123,共5页
Clinical Journal of Medical Officers
关键词
宫颈肿瘤
新辅助化疗
中性粒细胞与淋巴细胞比值
预后
Uterine cervical neoplasms
Neoadjuvant therapy
neutrophil-to-lymphocyte ratios
Prognosis
