中性粒细胞与淋巴细胞比值对非小细胞肺癌化疗近期疗效的预测价值

Predictive value of neutrophil-lymphocyte ratio in the short-term efficacy of chemotherapy for non-small cell lung cancer

目的:探讨化疗前中性粒细胞与淋巴细胞比值(NLR)与晚期非小细胞肺癌(NSCLC)化疗近期疗效的关系及潜在机制。方法:本研究纳入2018年1月至2019年10月武汉大学中南医院晚期NSCLC患者共75例,于化疗前进行静脉采血,检测中性粒细胞、淋巴细胞及淋巴细胞亚群计数。计算NLR值,并使用受试者工作特征(ROC)曲线计算得到NLR阈值为2.72,以此将患者分为高NLR组和低NLR组。分析NLR、淋巴细胞亚群计数与化疗近期疗效之间关系。结果:低NLR组(NLR<2.72)比高NLR组(NLR≥2.72)的近期化疗疗效明显较好(DCR 92.5%vs 68.6%,P=0.008)。比较外周血CD3+、CD3+CD4+、CD3+CD8+、B淋巴细胞和NK细胞计数,疗效控制组(PR+SD)明显高于疗效进展组(PD)(P<0.05),而且低NLR组明显高于高NLR组(P<0.05)。NLR与CD3+(P=0.009)、CD3+CD4+(P=0.015)、CD3+CD8+(P=0.020)、B淋巴细胞(P=0.026)、NK细胞(P=0.013)具有明显的负相关性(均为P<0.05)。结论:化疗前高NLR与较差的近期化疗疗效相关,其具体机制可能与机体免疫功能有关。

Objective:To explore the relationship between neutrophil-lymphocyte ratio(NLR)before che-motherapy and the short-term efficacy of chemotherapy in advanced non-small cell lung cancer(NSCLC)and its underlying mechanism.Methods:A total of 75 patients with advanced NSCLC from January 2018 to October 2019 were included in this study.Venous blood was collected before chemotherapy to detect neutrophil,lymphocyte,and lymphocyte subpopulation counts.The NLR val-ue was calculated,the receiver operating characteristic(ROC)curve was adopted to calculate the NLR threshold value of 2.72.In this way,the patients were divided into a high NLR group and a low NLR group.The relationship between NLR,lymphocyte subpopulation count,and short-term efficacy of chemotherapy was analyzed.Results:The short-term chemotherapy effect was significantly better in low NLR group(NLR<2.72)than in high NLR group(NLR≥2.72)(DCR 92.5%vs 68.6%,P=0.008).The levels of peripheral blood CD3^+,CD3^+CD4^+,CD3^+CD8^+B lymphocytes,and NK cell counts,were significantly higher in effect control group(PR+SD)than in effect progression group(PD)(P<0.05),and were significantly higher in low NLR group than in high NLR group(P<0.05).NLR has a significant negative correlation with CD3^+(P=0.009),CD3^+CD4^+(P=0.015),CD3^+CD8^+(P=0.020),B lymphocytes(P=0.026),and NK cells(P=0.013).Conclusion:High NLR before chemotherapy is associated with poor short-term chemotherapy efficacy,and the specific mechanism may be related to the body′s immune function.