中性粒细胞与淋巴细胞比值变化对肺大细胞神经内分泌癌患者预后的影响

The predictive value of pre-and postoperative neutrophil-lymphocyte ratio for pulmonary large cell neuroendocrine carcinoma patients

目的 探讨肺大细胞神经内分泌癌患者手术治疗前后外周血中性粒细胞/淋巴细胞比值（NLR）对预后的影响.方法 分析28例肺大细胞神经内分泌癌患者临床资料,单因素分析年龄、吸烟指数、病理类型、肿瘤分期、术前术后NLR、和术前NLR/术后NLR比值等对预后的影响,差异有统计学意义的单因素进入Cox回归模型进行多因素分析.结果 单因素分析显示年龄（P＜0.05）、吸烟指数（P＜0.05）、病理类型（P＜0.05）、肿瘤分期（P＜0.05）、术前NLR≥2.5（P ＜0.05）和术后NLR≥3.5（P＜0.05）影响患者预后.Cox回归分析显示肿瘤分期（P＜0.05）、术前NLR≥2.5（P ＜0.05）和术后NLR≥3.5（P ＜0.05）为影响患者术后生存率的独立危险因素.结论 对于接受手术的肺大细胞神经内分泌癌患者,术前术后NLR升高可能提示其预后不良.

Objective To analyze the impact of pre-and postoperative neutrophil-lymphocyte ratio （NLR） on the survival of patients with pulmonary large cell neuroendocrine carcinoma （LCNEC）.Methods The clinical data of 28 patients with pulmonary LCNEC were retrospectively reviewed,and the predictors of univariate analyses included gender,age,smoking history,pathological type and tumor stage,pre-and postoperative neutrophil-lymphocyte ratio （NLR） and preoperative NLR/postoperative NLR,etc.The analysis of Cox multiple regression was performed to determine the parameters of predicting the LCNEC prognosis.Results Univariate analysis showed that age （P 〈 0.05）,smoking history （P 〈 0.05）,pathological type （P 〈 0.05）,tumor stage （P 〈 0.05）,preoperative NLR ≥2.5 （P 〈 0.05） and postoperative NLR ≥ 3.5 （P 〈 0.05） were prognostic factors.Multivariate analysis revealed that tumor stage （P 〈0.05）,preoperative NLR ≥2.5 （P 〈0.05） and postoperative NLR ≥3.5 （P 〈 0.05） were independent prognostic factors.Conclusion The elevated pre-and postoperative NLR may predict the LCNEC patients with a poor prognosis after surgery.