术前加术后中性粒细胞与淋巴细胞比值预测胶质瘤患者的预后研究

Prediction on preoperative and postoperative neutrophil-to-lymphocyte ratio of clinical prognosis of patients with glioma

目的研究术前加术后外周血中性粒细胞与淋巴细胞比值(NLR)对胶质瘤患者预后的预测价值。方法回顾性分析110例经手术、病理检查确诊的胶质瘤患者的临床资料。将术前和术后NLR低于临界值的记为0,术前和术后NLR高于临界值的记为1。术前NLR加术后NLR记为PP-NLR,则PP-NLR=0或1或2;按患者的PP-NLR将其分为PP-NLR=0组、PP-NLR=1组和PP-NLR=2组。通过单因素及多因素分析确定影响患者总体生存期的危险因素。结果PP-NLR=0组、PP-NLR=1组及PP-NLR=2组间术前NLR和术后NLR的差异均有统计学意义(均P<0.001)。单因素分析显示,肿瘤病理级别、切除程度、放疗、化疗、术后NLR、PP-NLR是影响胶质瘤总体生存的危险因素(P<0.05~0.001)。多因素分析显示,未纳入PP-NLR时,肿瘤病理级别、切除程度、放疗、化疗、术后NLR是影响胶质瘤总体生存的独立危险因素(P<0.05~0.001);纳入PP-NLR后,肿瘤病理级别、切除程度、放疗、化疗、PP-NLR是影响胶质瘤总体生存的独立危险因素(P<0.05~0.001)。结论PP-NLR是影响胶质瘤患者预后的独立危险因素,且PP-NLR对胶质瘤患者预后的预测价值较单独的术前NLR或术后NLR更高。

Objective To study the predictive value of preoperative and postoperative neutrophil to lymphocyte ratio(NLR)in the prognosis of glioma patients.Methods The clinical data of 110 patients with glioma confirmed by operation and pathology were analyzed retrospectively.The preoperative and postoperative NLR lower than the critical value was recorded as 0,and the preoperative and postoperative NLR higher than the critical value was recorded as 1.The patients were divided into PP-NLR=0 group,PP-NLR=1 group and PP-NLR=2 group according to their PP-NLR.Univariate and multivariate analysis were used to determine the risk factors for overall survival.Results There were significant differences in preoperative and postoperative NLR among PP-NLR=0 group,PP-NLR=1 group and PP-NLR=2 group(all P<0.001).Univariate analysis showed that pathological grade,resection degree,radiotherapy,chemotherapy,postoperative NLR and PP-NLR were risk factors for overall survival of glioma(P<0.05~0.001).Multivariate analysis showed that when PP-NLR was not included,tumor pathological grade,resection degree,radiotherapy,chemotherapy and postoperative NLR were independent risk factors affecting the overall survival of glioma(P<0.05~0.001).When PP-NLR was included,tumor pathological grade,resection degree,radiotherapy,chemotherapy and PP-NLR were independent risk factors affecting the overall survival of glioma(P<0.05~0.001).Conclusion PP-NLR is an independent risk factor for the prognosis of glioma patients,and the predictive value of PP-NLR for the prognosis of glioma patients is higher than preoperative NLR or postoperative NLR alone.