术前炎症标志物和循环中MDSC与喉鳞癌患者预后的相关性分析

Correlation Analysis of Preoperative Inflammatory Markers and Circulating MDSC with Prognosis of Patients with Laryngeal Squamous Cell Carcinoma

目的探讨术前炎症标志物中性粒细胞与淋巴细胞比值(neutrophil to lymphocyte ratio,NLR)、血小板与淋巴细胞比值(platelet to lymphocyte ratio,PLR)、骨髓来源抑制细胞(myeloid-derived suppressor cell,MDSC)及血清白细胞介素-6(interleukin-6,IL-6)对喉鳞状细胞癌患者术后预后价值。方法采用Kaplan-Meier法进行生存分析,多因素COX回归分析预后的独立影响因素。通过流式细胞术分析检测外周血中MDSC所占外周血单个核细胞(peripheral blood mononuclear cell,PBMC)的比例,使用IL-6试剂盒检测血清IL-6,采用Pearson法检验相关性。结果NLR和PLR与喉鳞癌的预后相关(P<0.05)。NLR、PLR的最佳截断值分别为2.22、744.17,高NLR、高PLR的喉鳞癌患者的无复发生存期生存率更低;喉鳞癌患者外周血中MDSC及血清中IL-6较正常人显著升高(P<0.05);NLR、PLR越大时,外周血中MDSC及血清中IL-6越高;在高NLR组、高PLR组患者中外周血MDSC及血清IL-6也相对更高(P<0.05)。结论喉鳞癌患者术前NLR和PLR与其预后相关;同时,PLR为喉鳞癌的独立预后因素;外周血MDSC与IL-6结合术前炎症标志物NLR、PLR增加了喉鳞癌患者首次术后的预后预测价值。

Objective Objective To explore the prognostic value of preoperative inflammatory markers neutrophil to lymphocyte ratio(NLR),platelet to lymphocyte ratio(PLR),myeloid-derived suppressor cell(MDSC)and serum interleukin-6(IL-6)in patients with laryngeal squamous cell carcinoma.Methods Kaplan-Meier method was used for survival analysis,and multivariate COX regression was used to analyze the independent influencing factors of prognosis.The proportion of MDSC to peripheral blood mononuclear cell(PBMC)in peripheral blood was detected by flow cytometry,the serum IL-6 was detected by IL-6 kit,and the correlation was tested by Pearson test.Results NLR and PLR were associated with the prognosis of laryngeal squamous cell carcinoma patients(P<0.05).The optimal cut-off values of NLR and PLR were 2.22 and 744.17,respectively.The recurrence-free survival rate of laryngeal squamous cell carcinoma patients with high NLR and PLR is lower.MDSC in peripheral blood and IL-6 in serum of patients with laryngeal squamous cell carcinoma were significantly higher than those in normal subjects(P<0.05).The higher the NLR and PLR,the higher the MDSC in peripheral blood and IL-6 in serum.In patients with high NLR and high PLR,peripheral blood MDSC and serum IL-6 were also relatively higher(P<0.05).Conclusion The preoperative NLR and PLR of laryngeal squamous cell carcinoma patients are correlate with their prognosis.PLR is an independent prognostic factor of laryngeal squamous cell carcinoma.The combination of peripheral blood MDSC and IL-6 with preoperative inflammatory markers NLR and PLR increases the prognostic value of laryngeal squamous cell carcinoma patients after the first operation.