治疗前中性粒细胞淋巴细胞比值和血小板淋巴细胞比值对结外NK/T细胞淋巴瘤的预后价值

Prognostic value of neutrophil-lymphocyte ratio and platelet-lymphocyte ratio before treatment in extranodal NK/T-cell lymphoma

目的:探讨治疗前中性粒细胞淋巴细胞比值(neutrophil-lymphocyte ratio,NLR)和血小板淋巴细胞比值(platelet-lymphocyte ratio,PLR)在结外NK/T细胞淋巴瘤(extranodal natural killer/T-cell lymphoma,ENKTL)患者中的预后价值。方法:回顾性分析我院2012年01月至2016年12月新诊断的ENKTL患者的临床资料。根据受试者工作特征(ROC)曲线确定NLR和PLR的最佳截断值并对患者分组。采用卡方检验或Fisher确切概率法比较不同分组间的临床特征和近期疗效差异。我们使用Cox比例风险模型来确定与生存相关的单因素和多因素。生存曲线采用Kaplan-Meier法绘制,它们的差异采用log-rank检验分析。差异具有统计学意义(P<0.05)。结果:NLR和PLR的最佳截断值分别为2.62和228.8。治疗前NLR和PLR与B症状和EBV DNA拷贝数相关(P<0.05)。不同NLR、PLR分组的近期疗效差异无统计学意义(P>0.05)。单因素和多因素分析显示,NLR(P=0.009)、PLR(P=0.008)和LDH(P=0.019)是ENKTL患者OS的独立危险因素。高NLR或高PLR的患者OS率较低(P<0.001)。结论:治疗前NLR和PLR可作为结外NK/T淋巴瘤患者的独立预后因素,高NLR、高NLR提示患者预后不良。

Objective:To investigate the prognostic value of pretreatment neutrophil-lymphocyte ratio(NLR)and platelet-lymphocyte ratio(PLR)in patients with extranodal NK/T-cell lymphoma(ENKTL).Methods:The clinical data of newly diagnosed ENKTL patients in our hospital between January 2012 to December 2016 were retrospectively analyzed.The optimal cut-off values of NLR and PLR were calculated according to the receiver operating characteristic(ROC)curve,after which the patients were grouped.Differences in clinical characteristics and the short-term efficacy of treatment between the groups were analyzed using 2 or Fisher's exact tests.Univariate and multivariate survival analyses were performed using the Cox proportional hazards model to identify the risk factors affecting prognosis.The survival curves were drawn by the Kaplan-Meier method,and log-rank tests were used to compare the differences between the survival curves of each group.P<0.05 was considered statistically significant.Results:The optimal cut-off values for NLR and PLR were 2.62 and 228.8,respectively.Pretreatment PLR and NLR are correlated with B symptoms and EBV DNA copy number(P<0.05).There were no statistically significant differences in the short-term efficacy of treatment in the different NLR and PLR groups.Univariate and multivariate analysis showed that NLR(P=0.009),PLR(P=0.008)and LDH(P=0.019)were independent risk factors for overall survival in ENKTL patients.Patients with high NLR or high PLR had lower OS rates(P<0.001).Conclusion:Pretreatment NLR and PLR can be used as independent prognostic factors for patients with extranodal NK/T lymphoma,and high NLR and high NLR indicate poor prognosis.