PLR、NLR对食管鳞癌放化疗/放疗患者预后的影响

doi:10.16689/j.cnki.cn11-9349/r.2020.03.015

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摘要目的探讨治疗前血液炎性反应标志物：血小板与淋巴细胞比值、中性粒细胞与淋巴细胞比值对食管鳞癌放化疗/放疗患者预后的影响。方法回顾性分析2012年3月至2017年11月在四川省肿瘤医院行放化疗/放疗并经病理诊断明确的143例ESCC患者的临床病理资料及随访资料。通过ROC曲线的约登指数分别确定血小板与淋巴细胞比值（PLR）和中性粒细胞与淋巴细胞比值（NLR）的界限值，并分别将患者分为高值组和低值组。χ2检验比较不同分组之间的差异，采用Kaplan-Meier法计算总生存，并采用log-rank test进行单因素分析，Cox回归模型进行多因素分析。结果利用ROC曲线求得最佳PLR、NLR界值分别为196.67、3.55，低PLR组（<196.67）为120例，高PLR组（≥196.67）为23例；低NLR组（<3.55）为96例，高NLR组（≥3.55）为47例。放化疗/放疗前PLR和NLR水平与性别、年龄、肿瘤长度、T分期、N分期等临床病理特征均无关（P>0.05）。单因素分析显示T分期、N分期、治疗方式、PLR及NLR对ESCC患者的OS有影响（P<0.05）。多因素分析显示：PLR、治疗方式以及T分期是影响ESCC患者OS的独立预后因素（P<0.05），PLR比NLR更能预测ESCC患者预后。结论 PLR和NLR可预测ESCC患者的预后，PLR还可作为影响患者OS的独立预后因素。

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	李科
	李涛
	吕家华
	肖苓
	刘晓

Abstract：Objective To investigate the effect between platelet to lymphocyte ratio (PLR), neutrophil to lymphocyte ratio (NLR) and the prognosis of patients with esophageal squamous cell carcinom(ESCC) a undergoing chemoradiotherapy or radiotherapy. Methods Retrospective analysis was performed for 143 cases with histologically confirmed ESCC that underwent chemoradiotherapy or radiotherapy from March 2012 to November 2017. The cutoff values of NLR and PLR were determined by ROC curve, and the patients were divided into high value group and low value group respectively. The chi-square test was used to compare the differences between different groups；Kaplan-Meier method was used to calculate the overall survival (OS)；log-rank test method was used for univariate analysis and Cox regression model for multivariate analysis. Results ROC curve analysis showed that PLR ＝189, NLR=3.55 were optimal cut-off values, 120 cases in low PLR group (<196.67), 23 cases in high PLR group (≥ 196.67)；96 cases in low NLR group (<3.55), 47 cases in high NLR group (≥ 3.55).The level of PLR and NLR before chemoradiotherapy or radiotherapy was not related to sex, age, tumor length, T stage, N stage and other clinicopathological features(P>0.05).Univariate analysis showed that T stage, N stage, treatment method, PLR and NLR are correlated with the overall survival of patients with esophageal squamous cell carcinoma before chemoradiotherapy or radiotherapy(P<0.05). Multivariate analysis revealed that the PLR, treatment method and T stage were identified as independent prognostic factors for the overall survival of ESCC patients(P<0.05), PLR is better than NLR in predicting the prognosis of esophageal cancer patients. Conclusion PLR and NLR might predict the prognosis of ESCC patients. PLR could be an independent prognostic factor for ESCC.

通讯作者: 李涛，电子邮箱：litaoxmf@126.com

引用本文:

李科，李涛，吕家华，肖苓，刘晓. PLR、NLR对食管鳞癌放化疗/放疗患者预后的影响[J]. 肿瘤代谢与营养电子杂志, 2020, 7(3): 327-332.
Li Ke, Li Tao, Lyu Jiahua, Xiao Ling, Liu Xiao. Correlation between PLR, NLR and the prognosis of patients with esophageal squamous cell carcinoma undergoing chemoradiotherapy or radiotherapy. Electron J Metab Nutr Cancer, 2020, 7(3): 327-332.

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