中性粒细胞与淋巴细胞比率及其他血标志物与软组织肉瘤患者治疗后生存期的关系分析

The relationship between the ratio of neutrophils to lymphocytes and other blood markers and the postoperative survival of patients with soft tissue sarcoma

目的:探讨治疗前中性粒细胞与淋巴细胞比率及其他血液标志物水平在软组织肉瘤患者治疗后生存期中的影响。方法:对2012年4月~2014年12月经我院住院治疗的103例软组织肉瘤患者临床资料及生存随访调查进行回顾性分析,包括人口学特征资料、临床诊断结果以及治疗前血中中性粒细胞与淋巴细胞比率(NLR)、血小板与淋巴细胞比率(PLR)、淋巴细胞与单核细胞比率(LMR)等血液标志物,采用cox回归分析各因素对患者无进展是生存和总生存的影响。结果:单因素Cox回归分析显示,肿瘤直径、病理分期、NLR、LMR、化疗时机、手术切缘病理检验结果以及是否接受放疗与患者术后无进展生存期有关,肿瘤直径、NLR、化疗时机、手术切缘病理检验结果与患者术后总生存期有关(P<0.05)。而多元比例风险回归分析后,仅NLR为患者术后无进展生存期和总生存期的独立危险因素(P<0.05)。根据103例患者NLR中位数水平2.58将患者分为低NLR组和高NLR组,其中高NLR组患者无进展生存期和总生存期均较低NLR组患者缩短,差异具有统计学意义(P<0.05)。结论:治疗前低NLR水平与软组织肉瘤患者生存期有关,可能对预测患者术后生存期有一定的作用。

Objective:To investigate the effect of the ratio of neutrophils to lymphocytes and other blood markers on the posttherapeutic survival of patients with soft tissue sarcoma before treatment.Methods:Clinical data and survival follow-up survey of 103 patients with soft tissue sarcoma from April 2012 to December 2014 in our hospital were retrospectively analyzed.The data included demographic characteristics data,clinical diagnosis results and blood markers of blood neutrophil and lymphocyte ratio(NLR),platelet and lymphocyte ratio(PLR),the ratio of lymphocytes and mononuclear cells(LMR)before and after treatment,and analyzed the influence of the factors for progression-free survival and overall survival by cox regression analysis.Results:The single factor Cox regression analysis showed that tumor diameter,the pathological staging,NLR,cut edge,timing of chemotherapy,and surgery pathology inspection results and whether associated with progression-free surial after radiotherapy,the tumor diameter,cutting edge NLR,timing of chemotherapy,and surgery pathology inspection results related to patients'overall survival after surgery(P<0.05).After multivariate proportional risk regression analysis,only NLR was an independent risk factor for progression-free survival and overall survival(P<0.05).According to the median NLR level of 2.58,the 103 cases of patients were divided into the low-NLR group and the high-NLR group,in which the progression-free survival and overall survival of the patients in the high-NLR group were shorter than those in the low-NLR group,and the difference was statistically significant(P<0.05).Conclusion:The low NLR level before treatment is related to the survival of patients with soft tissue sarcoma,which may play a role in predicting the postoperative survival of patients.