治疗前外周血NLR和PLR与Ⅱ期鼻咽癌患者预后的相关性分析

Correlation analysis of NLR and PLR in peripheral blood before treatment with prognosis of patients with stageⅡnasopharyngeal carcinoma

目的探讨Ⅱ期鼻咽癌(NPC)患者治疗前外周血中性粒细胞/淋巴细胞比值(NLR)和血小板/淋巴细胞比值(PLR)对NPC预后的预测价值。方法回顾性分析2010年1月至2016年12月该院初诊194例Ⅱ期NPC患者的临床资料,记录外周血中性粒细胞、淋巴细胞、血小板计数,得出相应的NLR、PLR。采用受试者工作特征(ROC)曲线计算治疗前NLR、PLR的最佳截断值,以截断值为界,将NLR、PLR分别分为高、低两组,分析治疗前NLR、PLR对NPC患者无复发生存(RFS)时间的影响及其与临床病理资料的关系,采用Kaplan-Meier法计算生存率并行Log-rank检验,采用COX比例风险模型行多因素分析,确定影响NPC复发的独立危险因素。结果NLR、PLR的ROC曲线下面积(AUC)分别为0.790、0.657,截断值分别为2.415、148.400。单因素分析结果显示,TNM分期(P=0.034)、治疗前NLR(P<0.001)、治疗前PLR(P=0.003)与NPC患者复发有关。COX比例风险回归模型多因素分析结果显示,TNM分期中T_(2)N_(1)M_(0)[RR=5.287,95%CI(1.181,20.083),P=0.028]、治疗前NLR[RR=6.042,95%CI(1.818,20.083),P=0.003]是NPC患者复发的独立危险因素。结论TNM分期、治疗前高NLR是Ⅱ期NPC患者复发的独立危险因素。

Objective To investigate the predictive value of peripheral blood neutrophil to lymphocyte ratio(NLR)and platelet to lymphocyte ratio(PLR)before treatment in the patients with stageⅡnasopharyngeal carcinoma(NPC).Methods The clinical data of 194 patients newly diagnosed with stageⅡNPC in this hospital from January 2010 to December 2016 were analyzed retrospectively.The counts of neutrophils,lymphocytes and platelets in peripheral blood were recorded,and the corresponding NLR and PLR values were obtained.The best cut-off values of NLR and PLR before treatment were calculated by the receiver operating characteristic(ROC)curve.According to the cut-off values,NLR and PLR were divided into the high and low groups,respectively.The effects of NLR and PLR before treatment on the recurrence free survival time(RFS)of NPC patients and their relationship with clinical data were analyzed.The survival rate was calculated by Kaplan-Meier method,the Log-rank test and COX proportional hazards model multivariate analysis were adopted to determine the independent risk factors affecting the recurrence of NPC.Results The area under ROC curve(AUC)of NLR and PLR were 0.790 and 0.657,respectively,and the cut-off values were 2.415 and 148.400.The univariate analysis results showed that T_(2)N_(1)M_(0) of TNM stage(P=0.034),NLR(P<0.001)and PLR(P=0.003)before treatment were related to the recurrence of NPC.The multivariate analysis results of COX proportional hazards regression model showed that T_(2)N_(1)M_(0) of TNM stage[RR=5.287,95%CI(1.181,20.083),P=0.028]and NLR before treatment[RR=6.042,95%CI(1.181,20.083),P=0.003]were the independent risk factors for the recurrence of NPC patients.Conclusion The TNM stage and NLR increase before treatment were the independent risk factors for the recurrence of the patients with stageⅡNPC.