血小板与淋巴细胞比值同小细胞肺癌临床预后的相关性分析

doi:10.16689/j.cnki.cn11-9349/r.2019.02.008

摘要
图/表
参考文献
相关文章 (15)

全文: PDF (879 KB) HTML (1 KB)
输出: BibTeX | EndNote (RIS)

摘要目的本文主要探讨小细胞肺癌患者血小板与淋巴细胞比值同患者预后的关系。方法本文回顾性分析了首都医科大学附属北京康复医院2008年6月至2018年6月期间住院的小细胞肺癌患者共165例，收集患者血小板、淋巴细胞计数等临床资料，随访统计患者的生存期。通过SPSS 22.0统计软件中的ROC曲线，确定PLR的最佳界值，采用Kaplan-Meier法分析高PLR及低PLR组的生存，采用COX回归分析法行多因素分析。结果利用ROC曲线求得最佳PLR界值为189，低PLR组（<189）为120例，高PLR组（≥189）为45例。低PLR组患者的无进展生存期高于高PLR组（8.6个月vs 6个月，P=0.016），低PLR组患者总生存高于高PLR组（13.8个月vs12.1个月，P=0.016）。COX多因素回归分析结果示，是否行放疗既可作为影响SCLC患者PFS的独立预后因素（HR=0.488，95%CI=0.303～0.787，P=0.003），也可作为影响SCLC患者OS的独立预后因素（HR=0.314，95%CI=0.190～0.519，P=0.000）。而PLR水平仅作为影响SCLC患者PFS的独立预后因素（HR=1.538，95%CI=1.040～2.274，P=0.031），但不能作为OS的独立预后因素（HR=1.323，95%CI=0.883～1.982，P=0.175）。结论 PLR可以反映SCLC患者预后，但不能作为独立预后因素。

	服务

	把本文推荐给朋友
	加入我的书架
	加入引用管理器
	E-mail Alert
	RSS
	作者相关文章
	王立伟
	王键玮
	贾伟
	强薇
	薛梅
	马超
	魏秀芹

关键词 ：血小板与淋巴细胞比值, 小细胞肺癌, 预后

Abstract：Objective To investigate the relationship between platelet to lymphocyte ratio (PLR) and prognosis in patients with small cell lung cancer (SCLC). Methods Clinical data， including platelet and lymphocyte counts， of 165 patients with SCLC admitted to our hospital from June 2008 to June 2018 were collected and retrospectively analyzed and their survival were followed up. The optimal cut-off value of PLR was determined with time-dependent receiver operating curve (ROC curve) analysis in SPSS 22.0 statistical software. The overall survival (OS) and progression-free survival (PFS) of high PLR and low PLR groups were evaluated with Kaplan-Meier analysis respectively and Multivariate Cox regression models were applied to evaluate the independent prognostic significance of PLR. Results ROC curve analysis showed that PLR ＝ 189 was optimal cut-off value. One hundred and twenty cases were found in the low PLR (<189) group and 45 cases fell in the high PLR (≥189) group. The progression-free survival of patients with low PLR was higher than that of high PLR (8.6 months vs 6 months， P=0.016). The overall survival of patients with low PLR was higher than that of high PLR (13.8 months vs 12.1 months， P= 0.016). COX multivariate regression analysis showed that radiotherapy can be used as an independent prognostic factor for both PFS and OS in patients with SCLC(HR=0.488， 95%CI=0.303~0.787， P=0.003； HR=0.314， 95%CI=0.190~0.519， P=0.000. PLR level can be used as an independent prognostic factor for PFS in patients with SCLC (HR=1.538， 95%CI=1.040~2.274， P=0.031)， but not as an independent prognostic factor for OS (HR=1.323， 95%CI=0.883~1.982， P=0.175). Conclusion PLR can reflect the prognosis of patients with SCLC， but it cannot be used as an independent prognostic factor.

Key words： Platelet to lymphocyte ratio Small cell lung cancer Prognosis

通讯作者: 王立伟，电子邮箱：wlw168@126.com

引用本文:

王立伟，王键玮，贾伟，强薇，薛梅，马超，魏秀芹. 血小板与淋巴细胞比值同小细胞肺癌临床预后的相关性分析[J]. 肿瘤代谢与营养电子杂志, 2019, 6(2): 196-199.
WANG Li-wei， WANG Jian-wei， JIA Wei， QIANG Wei， XUE Mei， MA Chao， WEI Xiu-qin. Correlation between platelet/lymphocyte ratio and clinical prognosis of small cell lung cancer. Electron J Metab Nutr Cancer, 2019, 6(2): 196-199.

1.Chan BA， Coward JI．Chemotherapy advances in small-cell lung cancer. J Thorac Dis. 2013；5(suppl 5):s565-s578.
2.Li J， Dai CH， Chen P， et al. Survival and prognostic factors in small cell lung cancer. J Med Oncol. 2010；27(1):73-81.
3.Paesmans M， Sculier JP， Lecomte J， et al. Prognostic factors for patients with small cell lung carcinoma: analysis of a series of 763 patients included in 4 consecutive prospective trials with a minimum follow-up of 5 years. J Cancer. 2000；89(3):523-533.
4.Krug LM，Crapanzano JP， Azzoli CG， et al． Imatinib mesylate lacks activity in small cell lung carcinoma expressing c-kit proteina phase Ⅱ clinical trial. J Cancer. 2005；103(10):2128-2131．
5.Reck M，Luft A， Szczesna A， et al． Phase Ⅲ randomized trial of ipilimumab plus etoposide and platinum versus placebo plus etoposide and platinum in extensive-stage small-cell lung cancer. J Clin Oncol.2016；34(31):3740-3748．
6.Ott PA， Elez E， Hiret S，et al．Pembrolizumab in patients with extensive-stage small-cell lung cancer: results from the phase Ib KEYNOTE-028 study．J Clin Oncol.2017；35(34):3823- 3829．
7.Coussens LM， Werb Z. Inflammation and cancer. J Nature. 2002；420(6917):860-867.
8.Wu G， Yao Y， Bai C， et al．Combination of platelet to lymphocyte ratio and neutrophil to lymphocyte ratio is a useful prognostic factor in advanced non-small cell lung cancer patient．J Thorac Cancer.2015；6(3):275-287.
9.Miyamoto R， Inagawa S， Sano N， et al. The neutrophil-to-lymphocyte ratio (NLR) predicts short-term and long-term outcomes in gastric cancer patients. J Eur J Surg Oncol.2018；7983(18):30296-30298.
10.Chan JC， Chan DL，Diakos CI， et al.The lymphocyte-to-monocyte ratio is a superior predictor of overall survival in comparison to established biomarkers of resectable colorectal cancer．J Ann Surg. 2017；265(3):539-546．
11.Coussens LM， Werb Z. Inflammation and cancer. J Nature.2002；420:860-867.
12.Grivennikov SI， Greten FR， Karin M. Immunity， inflammation， and cancer. J Cell. 2010； 140(6):883-899.
13.Bambace NM， Holmes CE. The platelet contribution to cancer progression. J Thromb Haemost. 2011；9(2):237-249.
14.Goubran HA， Stakiw J， Radosevic M， et al. Platelet-cancer interactions. J Semin Thromb Hemost. 2014；40(3):296-305.
15.Alexandrakis MG， Passam FH， Moschandrea IA， et al. Levels of serum cytokines and acute phase proteins in patients with essential and cancer-related thrombocytosis. J Am J Clin Oncol. 2003；26(2):135-140.
16.Xu Z， Xu W， Cheng H， et al. The prognostic role of the platelet-lymphocytes ratio in gastric cancer: a Meta-analysis. J PLoS One. 2016；11(9):e0163719.
17.Krenn-Pilko S， Langsenlehner U， Thurner EM，et al．The elevated preoperative platelet-to-lymphocyte ratio predicts poor prognosis in breast cancer patients．J Br J Cancer. 2014；110(10):2524-2530．
18.王鑫，支修益.中性粒细胞/淋巴细胞比值和血小板/淋巴细胞比值对小细胞肺癌患者预后价值的相关研究.中国医学前沿杂志(电子版).2017；5.
19.王琳，吕喜英.外周血中性粒细胞与淋巴细胞比值、血小板与淋巴细胞比值对小细胞肺癌患者预后的评估价值.临床肺科杂志.2017；6.
20.Kang MH， Go SI， Song HN， et al. The prognostic impact of the neutrophil-to-lymphocyte ratio in patients with small-cell lung cancer. J Br J Cancer. 2014；111(3):452-460.