术前中性粒细胞/淋巴细胞比值和Glasgow评分对非小细胞肺癌预后的影响

Prognostic values of preoperative neutrophil-lymphocyte ratio and Glasgow prognostic score in non-small cell lung cancer patients

目的：探讨术前外周血中性粒细胞/淋巴细胞比值（NLR）、Glasgow评分（GPS）对肺癌患者预后的影响。方法：分析82例肺癌病人的临床资料,术前外周血NLR以中位数2.98为截取值分为低NLR组和高NLR组,GPS根据C-反应蛋白、白蛋白水平分为0、1、2分组,分析二者与临床病理特征的关系。采用单因素和多因素分析患者NLR、GPS评分与总生存时间的关系。结果：低NLR组与高NLR组中位生存时间（OS）分别为25.5、15.1个月,差异有统计学意义（P〈0.05）。Glasgow 0、1、2分组中位生存时间（OS）分别为27.1、16.7、11.6个月,差异有统计学意义（P〈0.05）。多因素分析显示NLR和GPS均是影响肺癌预后的独立危险因素（RR：2.864,95%CI：1.287~6.370,P=0.010;RR：1.838,95%CI：1.036~3.259,P=0.037）。结论：术前NLR和GPS均是影响肺癌预后的独立危险因素,NLR和GPS升高提示预后不良。

Objective： To explore whether preoperative neutrophil-lymphocyte ratio（ NLR） or Glasgow prognostic score are effective prognostic markers in non-small cell lung cancer（ NSCLC）. Methods： The preoperative data of 82 patients with NSCLC were collected. As prognostic factors,neutrophil-lymphocyte ratio（ NLR） and the Glasgow prognostic score（ GPS） determined by serum levels of C-reactive protein and albumin were evaluated. The NLR of 2. 98 was identified as the optimal cut-off value. The relationship between NLR,GPS and clinicopathologic variables and difference in clinical outcomes of different groups were analyzed. The prognostic impact of NLR and GPS on survival in NSCLC patients were tested by univariate and multivariate analyses. Results： The median overall survival of low NLR and high NLR groups were 25. 5 and 15. 1 months respectively（ P〈0. 05）. The median overall survival of GPS 0,1,2 groups were 27. 1,16. 7 and 11. 6 months respectively（ P〈0. 05）. Cox multivariate analysis showed that NLR and GPS were independent prognostic factors（ RR： 2. 864,95% CI： 1. 287 ~ 6. 370,P = 0. 010; RR： 1. 838,95%CI： 1. 036 ~ 3. 259,P = 0. 037）. Conclusion： Preoperative NLR and GPS were independent predictors of poor outcome after curative resection.