治疗前血中性粒细胞数目和白蛋白水平预测鼻咽癌预后的临床意义

Clinical significance of neutrophil and albumin pretreatments in nasopharyngeal carcinoma prognosis

目的:研究治疗前中性粒细胞、淋巴细胞、单核细胞及白蛋白水平与鼻咽癌患者预后的相关性。方法:选取401例在中山大学肿瘤医院进行初次诊断的鼻咽癌患者。记录患者免疫相关参数值及白蛋白水平。Kaplan-Meier和Log-rank分析比较总生存期和无进展生存期。采用Cox回归风险模型来确定预后因素。结果:治疗前高中性粒细胞>5.20×109/L(n=172)患者在总生存期和无进展生存期上均小于治疗前低中性粒细胞≤5.20×109/L(n=229)患者(P=0.014,P=0.009)。治疗前高白蛋白水平组>43.00 g/L(n=253)在总生存期和无进展生存期均高于治疗前低白蛋白组≤43.00 g/L(n=148)(P<0.001,P=0.006)。多因素分析发现治疗前中性粒细胞数目是鼻咽癌患者无进展生存期的独立预后因素,治疗前白蛋白水平是鼻咽癌患者总生存期的独立预后因素。结论:治疗前外周血中性粒细胞数目与白蛋白水平可作为鼻咽癌患者生存的独立预后因素。

Objective： To investigate the association ofpretherapeutic neutrophil, lymphocyte, monocyte, and serum albumin levels with nasopharyngeal carcinoma （NPC） prognosis in 401 patients. Methods： This study involved 401 NPC patients recently diagnosed and admitted in Sun Yat-sen University Cancer Center, China. Laboratory variables, such as immunology-related parameters and albumin level prior to treatment, were analyzed. The overall survival and disease-free survival rates were determined using the Kaplan-Meier method and were then compared using the log-rank test. Univariate and multivariate analyses were performed using the Cox proportional hazards model to identify prognostic factors. Results： Patients with neutrophil counts 〉5.20×10^9/L （n=172） had significantly lower overall survival and disease-free survival rates compared with those with neutrophil counts ≤5.20×10^9/L （n=229） （P=0.014, P=0.009）. In the 401 NPC cases, patients with high albumin levels （〉43.00 g/L; n=253） had significantly higher overall survival （P=0.000） and disease-free survival （P=0.006） rates compared with those with low albumin levels （≤ 43.00 g/L; n=148）. Multivariate analysis showed that the neutrophil level is an in- dependent risk factor for disease-free survival, whereas the albumin level is a strong independent prognostic factor for overall survival. Conclusion： The pretherapeutic neutrophil and albumin levels are independent prognostic factors for survival in NPC patients.