术前外周血指标对成人幕上室管膜瘤患者预后的影响

Analysis of preoperatively peripherally hematic factors in the prognosis of adult patients suffering from supratentorial ependymoma

目的研究术前外周血中性粒细胞淋巴细胞比率(NLR)、血小板淋巴细胞比率(PLR)、单核细胞淋巴细胞比率(MLR)、平均血小板体积(MPV)、血小板分布宽度(PDW)与成人幕上室管膜瘤预后的关系。方法回顾性分析2012年4月至2018年6月郑州大学第一附属医院收治的60例成人幕上室管膜瘤患者的资料,收集术前外周血NLR、PLR、MLR、MPV、PDW相关数据与术后总生存期(OS)、无进展生存期(PFS)。使用Kaplan-Meier生存分析法分别确定OS、PFS对应的术前外周血NLR、PLR、MLR、MPV、PDW分组的最佳界值并分组,使用单因素生存分析确定可能的预后指标。结合肿瘤切除程度、术前Karnofsky功能状态评分(KPS)、术后放疗、术后化疗、世界卫生组织(WHO)病理分级等其他因素行多因素分析确定独立预后因素。结果单因素生存分析示,NLR、WHO分级、术前KPS评分与5 a OS有关(均P<0.05),PDW、WHO分级、术后有无放疗、术后有无化疗与PFS有关(均P<0.05)。多因素分析示,NLR、术前KPS评分、WHO分级为OS的独立影响因素(均P<0.05),术前KPS评分、WHO分级为PFS的独立影响因素(均P<0.05)。结论术前外周血高NLR提示成人幕上室管膜瘤患者预后不良。

Objective To investigate the prognostic significance of preoperative peripheral blood neutrophil lymphocyte ratio(NLR), platelet lymphocyte ratio(PLR), monocyte lymphocyte ratio(MLR), mean platelet volume(MPV), platelet distribution width(PDW) in adult supratentorial ependymas.Methods The relationship between preoperative peripheral blood NLR, PLR, MLR, MPV, PDW and postoperative overall survival(OS) and progression-free survival(PFS) in 60 adult patients with supratentorial ependymoma in the First Affiliated Hospital of Zhengzhou University from April 2012 to June 2018 was analyzed. Kaplan-meier survival analysis was used to obtain the cut off values of these indicators for OS and PFS, and then patients were grouped according to the cut off values. Univariate survival analysis was used to assessment possible prognostic indicators. Independent prognostic factors were determined by multivariate analysis, including tumor resection degree, preoperative KPS(Karnofsky functional status score), postoperative radiotherapy, postoperative chemotherapy, WHO pathological grading and hematological factors.Results Univariate survival analysis showed that NLR, WHO grade and preKPS were related to 5 a OS(all P<0.05). PDW, WHO grading, postoperative radiotherapy and postoperative chemotherapy were related to PFS(all P<0.05). Multivariate analysis showed that NLR, preKPS and WHO grade were independent influencing factors for OS(all P<0.05), PreKPS and WHO grade were independent prognosic factors of PFS(all P<0.05). Conclusion Preoperative high NLR in peripheral blood suggests poor prognosis in adults with supratentorial ependymoma.