术前中性粒细胞/淋巴细胞比值与宫颈癌患者术后生存和复发的关系

The relationship between preoperative neutrophil to lymphocyte ratio and survival and recurrence of cervical cancer patients

目的:探讨术前中性粒细胞/淋巴细胞比值(NLR)与宫颈癌患者术后生存和复发的关系。方法:选取2012年1月至2014年12月我院收治的行手术治疗的宫颈癌患者136例。通过ROC曲线分别确定NLR的截断值,并以此为标准将宫颈癌患者分为高NLR组和低NLR组,对两组患者临床病理特征进行比较。应用Kaplan-Meier法绘制生存曲线,采用单因素及多因素COX回归分析NLR对宫颈癌术后生存和复发的影响。结果:高NLR组(NLR≥2.84)与低NLR组(NLR<2.84)的临床分期、病理分级、深肌层浸润、淋巴结转移及脉管浸润的差异有统计学意义(P<0.05)。高NLR组5年生存率明显低于低NLR组(71.1%vs 91.8%,P<0.01),高NLR组5年无病生存率明显低于低NLR组(52.6%vs 78.6%,P<0.01)。单因素及多因素COX回归分析显示,临床分期[HR(95%CI):2.104(1.435~2.827)]、淋巴结转移[HR(95%CI):3.826(2.752~5.914)]及术前NLR≥2.84[HR(95%CI):2.970(2.104~4.617)]是影响宫颈癌患者术后生存和复发的独立危险因素(P<0.05)。结论:术前NLR≥2.84是影响宫颈癌患者术后生存和复发的独立危险因素。

Objective:To investigate the relationship between preoperative neutrophil to lymphocyte ratio(NLR)and survival and recurrence of patients with cervical cancer after operation.Methods:136 cases of cervical cancer treated surgically in our hospital from January 2012 to December 2014 were selected.The truncation value of NLR was determined by ROC curve,and cervical cancer patients were divided into high NLR group and low NLR group.The clinical and pathological characteristics of the two groups were compared.Survival curve was drawn by Kaplan-Meier method.Univariate and multivariate COX regression were used to analyze the effect of NLR on survival and recurrence of cervical cancer after operation.Results:There were significant differences in clinical stage,pathological grade,deep muscle invasion,lymph node metastasis and vascular invasion between the high NLR group(NLR≥2.84)and the low NLR group(NLR<2.84)(P<0.05).The 5-year survival rate of the high NLR group was significantly lower than that of the low NLR group(71.1%vs 91.8%,P<0.01).The 5-year disease-free survival rate of the high NLR group was significantly lower than that of the low NLR group(52.6%vs 78.6%,P<0.01).Univariate and multivariate COX regression analysis showed that clinical stage[HR(95%CI):2.104(1.435~2.827)],lymph node metastasis[HR(95%CI):3.826(2.752~5.914)]and preoperative NLR≥2.84[HR(95%CI):2.970(2.104~4.617)]were independent risk factors for survival and recurrence of cervical cancer patients(P<0.05).Conclusion:Preoperative NLR≥2.84 is an independent risk factor for survival and recurrence of patients with cervical cancer after operation.