术前外周血中性粒细胞/淋巴细胞比值在评估非小细胞肺癌复发进展中的价值

The Value of Preoperative Neutrophil/Lymphocyte Ratio in Evaluating the Recurrence for Non-Small Cell Lung Cancer

目的:探究中性粒细胞/淋巴细胞比值(NLR)与非小细胞肺癌(NSCLC)根治术后复发进展的相关性。方法:回顾性分析2015年1月1日~2015年12月31日我院收治的111例行根治性手术切除的NSCLC患者临床病例资料,收集患者术前1周内血常规资料,计算NLR。对患者进行随访,随访截止时间为2020年2月29日,应用ROC曲线确定对患者术后短期复发进展有预测意义的NLR值,以此值为界限划分为NLR高组及NLR低组,应用Cox风险比例回归模型验证其是否为NSCLC根治术后患者短期复发进展的独立预后因素。结果:NLR对NSCLC患者术后复发进展有意义的预测值为2.733,曲线下面积(AUC)为0.752。Kaplan-Meier分析并Log-rank检验显示NLR升高组生存率较NLR降低组显著降低,差异有统计学意义(P<0.05)。Cox比例风险模型多因素分析显示,术前NLR(P=0.004,OR=1.253,95%CI:1.037~2.380)、T分期(P=0.005,OR=1.576,95%CI:1.149~2.136)、N分期(P=0.021,OR=1.120,95%CI:1.042~1.878)是NSCLC患者术后复发进展的独立影响因素(均P<0.05)。结论:术前NLR可能是预测NSCLC患者根治术后复发进展的独立因素。

Objective:To investigate the relationship between preoperative neutrophil/lymphocyte ratio(NLR)and the recurrence of non-small cell lung cancer(NSCLC)after radical operation.Methods:The clinical data of 111 patients with operable NSCLC admitted to our hospital from January 1,2015 to December 31,2015 were analyzed retrospectively.The blood routine data of patients within 1 week before surgery were collected and NLR was calculated.The patients were followed up until February 29,2020.The ROC curve was used to determine the NLR values that could predict the short-term recurrence and progression.All patients were divided into the high NLR group and the low NLR group according to the boundary value mentioned above.Cox proportional hazard model multivariate analysis was used to verify whether it was an independent prognostic factor for short-term recurrence and progression of patients with operable NSCLC.Results:The ROC curve showed that the optimal threshold of NLR for recurrence or progression prediction was 2.733,and the area under the curve(AUC)was 0.752.Kaplan-Meier analysis and Log-rank test suggested that the survival rate of the high NLR group was significantly lower than that of the low NLR group(P<0.05).Cox proportional hazard model multivariate analysis showed preoperative NLR(P=0.004,OR=1.253,95%CI:1.037 to 2.380),T staging(P=0.005,OR=1.576,95%CI:1.149 to 2.136),N staging(P=0.021,OR=1.120,95%CI:1.042 to 1.878)were independent prognostic factors for recurrence or progression in NSCLC patients.Conclusion:Preoperative NLR may be an independent influencing factor for predicting prognosis in operable NSCLC.