中性粒细胞与淋巴细胞比值预测小细胞肺癌预后的价值

Predictive value of neutral lymphocyte to lymphocyte ratio on the prognosis of small cell lung cancer

目的:探讨中性粒细胞与淋巴细胞比值(neutral lymphocyte to lymphocyte ratio,NLR)预测小细胞肺癌预后的价值。方法:共选取2005年1月至2010年12月于沈阳军区总医院肿瘤科确诊的小细胞肺癌患者96例,所有患者均完成至少6个周期一线含铂类方案化疗。患者化疗前3天检测血常规并计算NLR。根据NLR中位数将患者分为低NLR组(<3,68例)和高NLR组(≥3,28例),应用SPSS 17.0统计学软件进行分析。应用ROC曲线确定NLR的临界值,组间不同临床资料的构成比比较采用卡方检验,不同临床资料分组间NLR比较采用Kruskal-Walis检验。高/低NLR组间患者生存时间比较采用Kaplan-Meier检验,多因素分析采用Cox回归模型。检测NLR对患者生存预后的预测价值,并将影响5年生存率相关的临床病理因素进行单因素及多因素分析。结果:高NLR患者与低NLR患者在肿瘤分期上差异有统计学意义(P<0.05),余项比较无统计学差异。低NLR组患者的5年生存率(45.58%,31/68)显著高于高NLR组(28.57%,8/28),其差异有统计学意义(P<0.05)。高NLR和分期晚的患者预后差,Cox风险比例模型分析显示,肿瘤分期、白蛋白、NLR均是患者5年生存的预后不良因素。结论:小细胞肺癌患者初治前外周血NLR比值高提示生存预后较差。

Objective： To investigate the ratio of neutral lymphocyte and lymphocytes（ NLR） predictive value for the prognosis of small cell lung cancer. Methods： Selection of 96 cases of small cell lung cancer patients between January 2005 and December 2010 in the Oncology Department of Shenyang Military Region General Hospital,all patients were completed at least 6 cycles chemotherapy regimens including platinum. Three days before chemotherapy patients received routine blood detection and the NLR was calculated. According to the median NLR the patients were divided into low NLR groups（ 3,68 cases） and high NLR group（ 3 or higher,28 cases）,the application of SPSS 17. 0 statistical software for analysis. Using ROC curve to determine the critical value of NLR,the composition of clinical data between different groups by chi-square test,NLR comparison between different clinical data grouping by the Kruskal-Walis inspection,high/low NLR group patients survival time comparison by the Kaplan-Meier,multi-factor analysis by Cox regression model. To detect the predictive value of NLR on the prognosis and employed single factor and multiple factor analysis analyze the clinicopathologic factors that affect the 5-year survival rate. Results： High and low NLR patients in tumor staging was statistically significant（ P〈0. 05）,the remainder term is no statistical difference. The5-year survival rate of patients with low NLR group（ 45. 58%,31/68） was significantly higher than that of high NLR group（ 28. 57%,8/28）,the difference was statistically significant（ P〈0. 05）. Cox risk proportion model analysis shows that the tumor stage,albumin,NLR were 5 years of survival in patients with poor prognosis factors. Conclusion：Before primary treatment high peripheral blood NLR ratio indicates survival prognosis is poor in patients with small cell lung cancer.