术前血液学炎性反应标志物在胶质瘤患者预后中的价值

Predictive Value of Preoperative Hematologic Inflammatory Markers in Prognostic of Glioma Patients

目的探讨术前血液学炎性反应标志物(中性粒细胞与淋巴细胞比率(NLR)、单核细胞与淋巴细胞比率(MLR)和血小板与淋巴细胞比率(PLR))在胶质瘤患者临床预后中的预测价值。方法纳入180例胶质瘤患者。应用ROC曲线确定NLR、MLR和PLR的最佳临床分界值并分组。变量组间比较采用χ^2检验,通过Kaplan-Meier法和Log rank检验分析患者术后生存情况。Cox多因素回归分析预后因素。Pearson’s相关系数检验标志物间的相关性。结果 NLR、MLR和PLR的最佳分界值分别为1.90、0.33和133.38。高NLR和MLR组患者中位总生存期分别为16.8和14.8月,低NLR和MLR组分别为40.5和24.6月(均P<0.05)。高NLR组中位肿瘤复发时间为10.3月,低NLR组为28.8月(P=0.002)。NLR是胶质瘤患者的独立危险因素(HR=1.725, 95%CI:1.042~2.853, P=0.034)。且NLR与MLR(r=0.62,P<0.001)和PLR(r=0.59,P<0.001)具有相关性。结论术前高NLR、MLR与胶质瘤患者不良预后相关,且NLR是患者生存的独立预后因素,与肿瘤复发率密切相关。

Objective To explore the predictive value of pre-operative hematologic inflammatory markers NLR, MLR and PLR in the clinical prognosis of glioma patients. Methods We enrolled 180 patients with glioma. ROC curve was used to determine the optimal cutoff values of NLR, MLR and PLR and we divided groups accordingly. The differences of parameters were analyzed by χ^2 test. The Kaplan-Meier and Log rank methods were used to analyze patients’ survival after operation. The independent prognostic factors were evaluated by multivariate Cox regression analyses. Pearson’s correlation coefficient tested the correlations among these hematologic inflammatory markers. Results The optimal cutoff values of NLR, MLR and PLR were 1.90, 0.33 and 133.38, respectively. The median overall survival time of the patients with high NLR and MLR were 16.8 and 14.8 months, and those with low NLR and MLR were 40.5 and 24.6 months, respectively(all P<0.05). The median tumor recurrence time were 10.3 and 28.8 months in the high and low NLR groups, respectively(P=0.002). NLR was an independent risk factor for glioma patients(HR=1.725;95%CI:1.042-2.853;P=0.034). NLR was correlated with MLR(r=0.62;P<0.001) and PLR(r=0.59;P<0.001).Conclusion Preoperative high NLR and MLR are related to poor prognosis of patients with glioma, and NLR is an independent prognostic factor and closely related to tumor recurrence rate.