NLR、PLR与晚期非小细胞肺癌预后的相关性分析

Neutrophils/Lymphocyte Ratio(NLR)and Platelet/Lymphocyte Ratio(PLR)Associated with Prognosis of Advanced Non-Small Cell Lung Cancer

目的探讨中性粒细胞/淋巴细胞比值(NLR)、血小板/淋巴细胞比值(PLR)与晚期非小细胞肺癌(NSCLC)患者临床病理特征的相关性及其对预后的影响。方法采用回顾性研究,选择2017年1月—2018年7月就诊于天津中医药大学第一附属医院肿瘤科的晚期NSCLC患者62例为研究对象,其中男42例,女20例,年龄35~86(65.60±8.91)岁,分析晚期NSCLC患者临床病理特征中年龄、性别、吸烟史、病理类型、临床分期、辨证分型、NLR、PLR与预后的相关性,对晚期NSCLC患者预后的影响因素进行单因素及多因素分析。结果晚期NSCLC患者不同TNM分期的NLR[ⅢB期(3.26±1.16),Ⅳ期(3.92±1.34)]、PLR[ⅢB期(166.59±44.78),Ⅳ期(206.85±68.55)]差异有统计学意义(P<0.05),晚期NSCLC患者病理分型中鳞癌(4.17±1.29)与腺癌(3.42±1.19)NLR水平比较差异有统计学意义(P<0.05),晚期NSCLC患者中医辨证中痰热阻肺型(222.13±75.45)与肺阴虚型(151.04±29.16)PLR水平比较差异有统计学意义(P<0.05);晚期NSCLC患者TNM分期、中医虚实辨证与高低NLR、PLR分组存在相关性(P<0.05);辨证证型是晚期NSCLC患者无进展生存预后的影响因素(P>0.05);TNM分期、NLR、PLR是晚期NSCLC患者无进展生存预后的独立影响因素(P<0.05)。结论NLR、PLR对评估晚期NSCLC患者预后有一定预测价值。

Objective This retrospective study assessed the correlation of neutrophils/lymphocyte ratio(NLR)and platelet/lymphocyte ratio(PLR)with the prognosis of patients with advanced non-small cell lung cancer(NSCLC).Methods A total of 62 patients with advanced NSCLC were recruited from Department of Oncology,The First Teaching Hospital of Tianjin University of Traditional Chinese Medicine between January 2017 and July 2018,among which 42 were males and 20 were females with a mean age of 65.60±8.91 years ranging between 35 and 86 years.The correlation between age,gender,smoking history,pathological type,clinical stage,syndrome differentiation and NLR or PLR was analyzed.Univariate and multivariate analyses were performed to identify the prognostic factors of patients with advanced NSCLC.Results The NLR and PLR were lower in StageⅢB than in stageⅣNSCLC patients[(3.26±1.16)vs.(3.92±1.34),and(166.59±44.78)vs.(206.85±68.55),respectively;P<0.05].NLR level was higher in lung squamous carcinoma than in adenocarcinoma[(4.17±1.29)vs.(3.42±1.19);P<0.05].Furthermore,NLR was higher in the Phlegm-heat resistance lung type than in the lung Yin deficiency type[(222.13±75.45)vs.(151.04±29.16);P<0.05]according to the Traditional Chinese Medicine(TCM)syndrome differentiation status.The NSCLC TNM stage and TCM syndrome differentiation status were also associated with the level of NLR and PLR(P<0.05).The NSCLC TNM stage,NLR,and PLR were all independent factors in the prediction of the progress free survival of these patients(P<0.05),while the TCM syndrome differentiation was not an influential factor in association with the progress free survival of patients with advanced NSCLC(P>0.05).Conclusion Detection of NLR and PLR was able to predict the progression-free survival of patients with advanced NSCLC.