摘要
背景与目的已有的研究表明中性粒细胞计数/淋巴细胞计数比(neutrophil-to-lymphocyte ratio,NLR)对胃癌、结直肠癌、胰腺癌等多种恶性肿瘤的预后有显著影响,但是其对可切除肺腺癌患者预后影响目前研究较少。本研究旨在分析NLR与肺腺癌患者术后临床病理特征及预后的关系。方法回顾性分析163例经病理确诊为肺腺癌并行肺腺癌根治切除术患者的临床随访病理资料。根据术前1周内化验结果计算NLR值。通过对受试者工作特征曲线(receiver operating characteristic curve,ROC)的分析得出NLR的临界值(cut-off值)。采用Kaplan-Meier生存曲线和Cox比例风险模型研究NLR对肺腺癌术后患者预后的影响。结果采用5年生存作为终点绘制NLR值的ROC曲线,当NLR值为2.96时,正确指数(Youden指数)最大,敏感度为77.5%,特异度为75.9%。低NLR组累计5年生存率显著高于高NLR组(P<0.05)。单因素及多因素生存分析显示:TNM分期和NLR水平与生存率显著相关(P<0.05)。结论NLR值作为一项便捷且有效的指标,可用于初步判断肺腺癌术后患者预后状况。
Background and objective Previous studies have shown that the neutrophil-to-lymphocyte ratio（NLR） has a significant impact on the prognosis of many malignant tumors such as gastric cancer, colorectal cancer and pancreatic cancer, but the study on the prognosis of patients with resectable lung adenocarcinoma is less. The aim of this study is to investigate the correlation between the NLR and the clinicopathologic features of adenocarcinoma of lung patients who underwent radical pneumonectomy. Furthermore, this study aimed to clarify the predictive and prognostic significance of NLR in patients who underwent pneumonectomy for lung adenocarcinoma. Methods This study reviewed the medical records of 163 patients with lung adenocarcinoma who underwent pneumonectomy. The receiver operating characteristic（ROC） curve and Youden index were used to determine the cut-off value of the NLR. Survival curves were described by Kaplan-Meier method and compared by Log-rank test. The univariate and multivariate analyses were performed with the Cox proportional hazard model to identify the prognostic factors. Results When the NLR value was 2.96, the Youden index was maximal, with a sensitivity of 77.5% and a specificity of 75.9%. The 5-year survival rate in the low NLR group was higher than that in the high NLR group（P〈0.05）. The univariate and multivariate analyses showed that TNM staging and NLR were independent factors in predicting survival rate. Conclusion The NLR value was a simple and useful tool to predict the prognosis of lung adenocarcinoma after radical pneumonectomy.
作者
王高祥
熊燃
吴汉然
徐广文
李彩伟
孙效辉
解明然
Gaoxiang WANG;Ran XIONG;Hanran WU;Guangwen XU;Caiwei LI;Xiaohui SUN;Mingran XIE(Department of Thoracic Surgery,Anhui Provincial Hospital Affiliated to Anhui Medical University,Hefei 230001,China)
出处
《中国肺癌杂志》
CAS
CSCD
北大核心
2018年第8期588-593,共6页
Chinese Journal of Lung Cancer
基金
安徽省自然基金(No.1708085MH179)资助~~
