肺癌患者血清淋巴细胞-单核细胞比值、中性粒细胞-淋巴细胞比值及血小板-淋巴细胞比值变化及对预后的预测价值

Changes and prognostic value of serum lymphocyte/monocyte ratio,neutrophil/lymphocyte ratio and platelet/lymphocyte ratio in patients with lung cancer

目的探讨肺癌患者血清淋巴细胞-单核细胞比值(LMR)、中性粒细胞-淋巴细胞比值(NLR)、血小板-淋巴细胞比值(PLR)变化及对预后的预测价值。方法选取2015年1月至2018年5月我院诊治的肺癌患者90例(肺癌组),选取同期健康体检者90例(对照组),检测两组血清中的LMR、NLR、PLR变化,根据预后将肺癌组分为生存组和死亡组,比较两组血清LMR、NLR、PLR水平。分析对预后的预测价值及影响因素。结果肺癌组LMR、NLR、PLR水平高于对照组(P<0.05);生存组LMR、NLR、PLR水平低于死亡组(P<0.05);LMR、NLR、PLR的最佳诊断截点分别为5.93、3.28、139.38;LMR、NLR、PLR联合预测的AUC高于LMR、NLR和PLR(P<0.05);生存组和死亡组在病理类型、TNM分期、淋巴结转移、远处转移、LMR水平、NLR水平、PLR水平方面比较差异有统计学意义(P<0.05);病理类型、远处转移、NLR水平、PLR水平为影响肺癌患者预后的独立危险因素(P<0.05)。结论肺癌患者血清LMR、NLR、PLR水平升高,可用于预测在常规临床实践中肺癌患者的预后。

Objective To explore the changes and prognostic value of serum lymphocyte/monocyte ratio(LMR),neutrophil/lymphocyte ratio(NLR)and platelet/lymphocyte ratio(PLR)in patients with lung cancer.Methods A total of 90 patients with lung cancer treated in our hospital were enrolled between January 2015 and May 2018 as a lung cancer group,while other 90 healthy controls during the same period were enrolled as a control group.The changes of blood LMR,NLR and PLR in both groups were observed.According to the prognostic outcome,the lung cancer group was further divided into a survival group and a death group.The levels of serum LMR,NLR and PLR were compared between the two groups.Their predictive value for prognosis and influencing factors of prognosis were analyzed.Results The levels of LMR,NLR and PLR in the lung cancer group were higher than those in the control group(P<0.05),and the levels were lower in the survival group than those in the death group(P<0.05).The best diagnostic cut-off values of LMR,NLR and PLR were 5.93,3.28 and 139.38,respectively.The area under curve(AUC)of ROC curve analysis for LMR combined with NLR and PLR on predicting prognosis was greater than that of any indicator alone(P<0.05).The differences in pathological types,TNM staging,lymph node metastasis,distant metastasis,levels of serum LMR,NLR and PLR between the survival group and the death group were statistically significant(P<0.05).The multivariate regression analysis showed that pathological type,distant metastasis,NLR level and PLR level were independent risk factors of prognosis in the lung cancer patients.Conclusion The levels of blood LMR,NLR and PLR are increased in lung cancer patients.These can predict the prognosis of lung cancer patients in routine clinical practice.