淋巴细胞与单核细胞比值在早期结外NK/T细胞淋巴瘤中的预后意义

The prognostic significance of pretreatment lymphocyte to monocyte ratio for early stage extranodal Natural Killer/T cell lymphoma

目的探讨治疗前淋巴细胞与单核细胞比值(LMR)在早期结外NK/T细胞淋巴瘤(extranodal Natural Killer/Tcell lymphoma,ENKTL)(鼻型)预后中的意义。方法回顾性分析我院2008年1月至2016年11月收治的184例早期ENKTL患者的临床资料。结果通过ROC曲线获取LMR的截断值(cut-off值)为3.05,分为低LMR组(<3.05)和高LMR组(≥3.05)。获得完全缓解120例(65.2%),部分缓解48例(26.1%),总有效率91.3%。中位随访21.5个月,低LMR组的无进展生存(PFS)和总生存(OS)差(P<0.05)。单因素分析显示LMR<3.05、血小板/淋巴细胞比值(PLR)≥208.64、血红蛋白(HB)<126.5 g/L、ECOG评分≥2、韩国预后指数(KPI)≥2、stage IIE、乳酸脱氢酶(LDH)>240U/L、Non-CR对预后有影响(P<0.05)。多因素分析显示LMR、ECOG、Non-CR是影响患者预后的独立因素(P<0.05)。结论 LMR是ENKTL患者简单易行的生物学预后标志。

Objective To explore the prognostic significance of pretreatment lymphocyte to monocyte ratio （LMR） for early stage extranodal Natural Killer/T cell lymphoma （ENNKTL, nasal type）. Methods One hundred and eighty-four patients with early stage ENKTL from January 2008 to November 2016 were retrospectively analyzed. Results An optimal cutoff value of 3.05 for LMR was obtained by using the ROC analysis. The patients were divided into the low LMR group （ 〈3.05 ） and the high LMR group （ ≥ 3.05 ）. There were 120 （65. 2% ） patients with complete remission （CR） and 48 （26. 1% ） with partial remission （PR）. Thus, overall response rate （ORR） was 91.3%. The median follow-up time was 21.5 months. The low LMR group was associated with worse progress free survival （PFS） and overall survival （OS） （all P 〈 0. 05 ）. Univariate analysis showed that LMR〈3.05, platelet to lymphocyte ratio （PLR） ≥ 208.64, HB〈 126. 5 g/L, ECOG score ≥ 2, KPI score ≥2, stage IIE, LDH〉240U/L and non-complete remission （Non-CR） had significant influence on prognosis （ all P 〈 0.05 ）. Multivariate analysis showed that LMR, ECOG scores and Non-CR were independent prognostic risk factors （ all P 〈 0. 05）. Conclusion LMR was simple and feasible biomarker for prognosis of ENNKTL patients.