NLR、LMR和PLR与食管鳞癌患者预后的关系

Relationship between NLR,LMR,PLR and the prognosis of esophageal squamous cell carcinoma

目的探讨中性粒细胞-淋巴细胞比值(NLR)、淋巴细胞-单核细胞比值(LMR)和血小板-淋巴细胞比值(PLR)预测食管鳞癌患者预后的价值。方法回顾性分析接受治疗的1 061例食管鳞癌患者的临床资料,均经病理证实,计算初次诊断为食管鳞癌时NLR、LMR和PLR,分析NLR、LMR和PLR与临床病理特征和预后的关系。结果以NLR=2.46、LMR=200.26和PLR=3.88为界,高NLR组患者的5年生存率为19.10%,低NLR组的5年生存率为47.07%(P<0.001),高LMR组患者的5年生存率为57.00%,低LMR组的5年生存率为26.00%(P=0.006),高PLR组患者的5年生存率为40.15%,低PLR组的5年生存率为42.98%(P=0.283)。单因素分析显示性别、年龄、肿瘤标志物Cyfra21-1和鳞状细胞癌水平、食管癌分期、NLR水平、PLR水平、LMR水平均与患者预后显著相关(P<0.05)。用这些因素进行多因素Cox回归分析显示,性别、年龄、NLR水平、LMR水平是影响患者总体生存率的独立预后因素。结论 NLR和LMR是预测食管鳞癌患者预后的指标之一,NLR≥2.46、LMR<200.26者生存期较短。

Objective To investigate the prognostic significance of the neutrophil-to-lymphocyte ratio （NLR）, lym- phocyte-to-monocyte ratio （LMR） and platelet-to-lymphocyte ratio （PLR） in patients with esophageal squamous cell carcinoma（ESCC）. Methods A restropective review was performed on 1 061 patients who diagnosed ESCC. All patients were diagnosed with ESCC by pathological examination. Results Based on these cut-off value, NLR = 2. 46 ,LMR =200. 26 and PLR = 3.88 ,the 5-year overall survival rate was 19. 10% in patients of the high NLR group and 47. 07%in those of the low NLR group（P 〈0. 001 ）. The 5-year overall survival rate was 57. 00%in pa- tients of the high LMR group and 26.00% in those of the low LMR group（P = 0. 006）. The 5-year overall survival rate was 40. 15 % in patients of the high PLR group and 42.98% in those of the low PLR group （ P = 0. 283 ）. Single factor analysis showed that gender, age, esophageal stage, tumor markers Cyfra21-1 and squamous cell carcinoma an- tigen, NLR, PLR and LMR were significant correlated with the prognosis of patients （P 〈 0.05）. Multivariate Cox regression analysis showed that gender, age, NLR levels, and LMR levels were independent prognostic factors for o- verall survival in patients. Conclusion NLR and LMR are one of the predictors of prognosis in patients with e- sophageal squamous cell carcinoma, NLR ≥2. 46 and LMR 〈 200. 26 have shorter survival time.