外周血中性粒细胞与淋巴细胞比值以及血小板与淋巴细胞比值评估声门型喉癌患者预后的价值

Prognostic values of peripheral blood neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio in patients with glottic laryngeal squamous cell carcinomas

目的探讨外周血中性粒细胞与淋巴细胞比值(NLR)和血小板与淋巴细胞比值(PLR)与声门型喉鳞状细胞癌患者预后的关系。方法收集115例有明确病理诊断的声门型喉鳞状细胞癌患者的临床病理及随访资料,通过建立受试者工作特征曲线(ROC曲线),确定术前外周血NLR及PLR预测术后生存的最佳截点,以此将患者分为低NLR和高NLR组以及低PLR和高PLR组,分析NLR及PLR与患者的临床病理特征之间的关系,并通过单因素及多因素分析评估术前外周血NLR及PLR对患者术后生存的影响。结果115例患者中获得随访107例,失访8例,随访率为93.0%。随访患者中27例死于喉鳞状细胞癌,80例生存。根据ROC曲线计算出PLR、NLR的临界值分别为139.79和2.83。107例声门型喉鳞状细胞癌患者的5年生存率为74.8%,其中低PLR组患者的5年生存率为82.7%;高PLR组患者的5年生存率为56.3%,差异具有统计学意义(P=0.004)。低NLR组患者的5年生存率为81.8%;高NLR组患者的5年生存率为56.7%,差异具有统计学意义(P=0.003)。单因素分析显示,声门型喉鳞状细胞癌患者的预后与患者的T分期、有无淋巴结转移、NLR水平和PLR水平有关(P均<0.05)。多因素分析显示,PLR水平以及NLR水平为影响声门型喉鳞状细胞癌患者预后的独立因素(P均<0.05)。结论PLR和NLR可能是影响声门型喉鳞状细胞癌患者预后的独立因素。

Objective To investigate the relationships between the peripheral blood neutrophils-to-lymphocytes ratio(NLR)and platelet-to-lymphocytes ratio(PLR)and the prognosis of patients with glottic squamous cell carcinoma(GSCC).Methods Clinicopathological and follow-up data of 115 patients with GSCC were collected and reviewed.The best cut-off points of preoperative peripheral blood NLR and PLR for predicting postoperative survival were determined by establishing the receiver working characteristic curve(ROC curve).The patients were divided into low NLR and high NLR groups,low PLR and high PLR groups.The relationships between NLR,PLR and the clinicopathological characteristics of the patients were analyzed.The predictive effects of preoperative peripheral blood NLR and PLR on postoperative survival were evaluated by univariate and multivariate analyses.Results Of all the 115 patients,107 were followed up with a follow-up rate of 93.0%.Out of the 107 patients,27 died of laryngeal squamous cell carcinoma and 80 survived.According to the ROC curve,the critical values of PLR and NLR were 139.79 and 2.83 respectively.The total 5-year survival rate of the 107 patients was 74.8%.The 5-year survival rate of patients with low PLR was 82.7%,whereas that with high PLR was 56.3%,the difference was statistically significant(P=0.004).The 5-year survival rate of patients with low NLR was 81.8%,while that with high NLR was 56.7%,and the difference was statistically significant(P=0.003).Univariate analysis showed that the prognosis of GSCC patients was related to T stage,lymph node metastasis,NLR level and PLR level(all P<0.05).Multivariate analysis revealed that the PLR and NLR were independent factors affecting the prognosis of GSCC patients(all P<0.05).Conclusion PLR and NLR may be independent factors affecting the prognosis of GSCC patients.