术前外周血中性粒细胞及血小板与淋巴细胞比值对子宫内膜癌患者预后的影响

Correlation of neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio with the prognosis of endometrial carcinoma

目的子宫内膜癌是女性生殖系统最常见的恶性肿瘤之一。文中探讨外周血中性粒细胞与淋巴细胞比值(NLR)以及血小板与淋巴细胞比值(PLR)与子宫内膜癌预后的关系。方法回顾性分析郑州大学第二附属医院2009年6月至2012年6月期间收治的153例子宫内膜癌,并行手术治疗患者的临床及随访资料。通过ROC曲线分别确定NLR及PLR的截断值,并以此为标准将患者各分为高值组和低值组,分别讨论NLR和PLR与临床病理资料及预后的关系。结果 NLR高值组(NLR>3.40)与低值组(NLR≤3.40)在FIGO分期、病理分级、浸润深度、淋巴结是否转移等方面差异均有统计学意义(P<0.05)。PLR与子宫内膜癌预后无显著相关性(P>0.05)。Cox回归分析显示,FIGO分期Ⅲ~Ⅳ期(P<0.001)、病理分级G3(P=0.022)和NLR>3.4(P=0.004)是影响子宫内膜癌患者总生存率和无病生存率的独立危险因素。结论术前高NLR值的子宫内膜癌患者与其FIGO分期、病理分级、浸润深度、淋巴结转移密切相关。

Objective Endometrial cancer （EMC） is a most common malignancy in the female reproductive system. The purpose of this study was to investigate the relationship of the neutrophil-to-lymphocyte ratio （NLR） and platelet-to-lymphocyte ratio （PLR） with the prognosis of EMC.Methods We retrospectively analyzed the clinical and follow-up data about 153 EMC patients surgically treated in the Second Affiliated Hospital of Zhengzhou University. Based on the cutoff values of NLR and PLR, we divided the patients into a high and a low value group, and analyzed the relationships of NLR and PLR with clinical pathological features and prognosis of the patients.Results There were statistically significant differences between the high value group （NLR〉3.40） and the low value group （NLR≤3.40） in the FIGO stage, pathological grade, invasion depth, and lymph node metastasis （P〈0.05）. No significant correlation was found between the PLR and the prognosis EMC （P〉0.05）. COX regression analysis showed that FIGO stage Ⅲ-Ⅳ （P〈0.001）, pathological grade G3 （P=0.022） and NLR〉3.4 （P=0.004） were independent risk factors for the overall survival and disease-free survival of the EMC patients.Conclusion High preoperative NLR was closely related with the FIGO stage, pathological grade, invasion depth, and lymph node metastasis in patients with endometrial cancer.