小细胞肺癌患者中性粒细胞淋巴细胞比值与临床预后的相关因素分析  

Analysis of relation of neutrophil lymphocyte ratio and prognosis of small cell lung cancer patients

作　　者：黄燚[1] 刘丹[2] 李为民[2] 张立[3] 李镭[2] 余何[2] 李丹[2] 程越[2] 景玉婷[2] 周萍[2] 宋娟[2] 周永召[2] 甘云翠 

机构地区：[1]四川省人民医院检验科,四川成都610072 [2]四川大学华西医院呼吸与危重症医学科,四川成都610041 [3]四川大学华西医院移植免疫实验室,四川成都610041

出　　处：《西部医学》2016年第1期109-112,共4页Medical Journal of West China

基　　金：国家自然科学基金(81201851);四川省科技厅科技支撑计划(2014SZ0231)

摘　　要：目的探讨初次诊断小细胞肺(small cell lung cancer,SCLC)癌患者中性粒细胞与淋巴细胞比值(neutrophil lymphocyte ratio,NLR)与患者预后的关系及其临床意义。方法收集112例初次诊断未经治疗的小细胞肺癌患者的临床资料进行回顾性分析,利用ROC曲线确定NLR的cutoff值。通过门诊或电话随访获得患者生存情况等资料。采用SPSS17.0软件进行统计处理,不同临床特征组间NLR水平比较采用Mann-Whitney U检验,高低NLR组间患者总体生存时间比较采用Kaplan-Meier检验,多因素分析采用Cox回归模型。所有检验均为双侧。结果患者NLR平均值为(3.88±2.54),其中高NLR组(NLR≥4.5)中患者32例,低NLR组中(NLR<4.5)患者80例。NLR在不同年龄、分期、血清ALB及LDH水平分组中差异有统计学意义(均P<0.05)。低NLR组患者总体生存时间显著高于高NLR组(中位生存时间17月vs 10月,2=13.043,Log-Rank P=0.000)。多因素分析结果表明初诊患者NLR(HR1.658,95%CI 1.036-2.653 P=0.035)、年龄(HR:1.795,95%CI:1.163-2.771,P=0.008)及肿瘤分期(HR:2.535,95%CI:1.523-4.220,P=0.000)是SCLC预后的独立风险因素。结论初次诊断小细胞肺癌的患者,临床采用NLR对评估患者的临床预后具有一定价值。Objectives To explore the relationship between neutrophil lymphocyte ratio （NLR） at diagnosis and o- verall survival time of patients with small cell lung cancer （SCLC） and its clinical significances. Methods 112 SCLC pa- tients were included and retrospectively analyzed. The pretreatment clinical parameters were collected. The optimal cutoff value for NLR was determined using time-dependent receiver operating curve （ROC） analysis. SPSS17.0 software was used for analysis. Continuous variables were expressed as mean with standard deviation （SD）. NLR values and different clinical characteristic groups were compared by Mann-Whitney U-test. The overall survival analyses were performed by the Kaplan-Meier method. Significant differences between groups were identified using the log-rank test. Multi-variate analyses for survival were performed by Cox-proportional hazards model, and the associated 95 % confidence interval was calculated. All tests were two-sided, and P〈0.05 was considered statistical significant. Results The mean NLR was 3.88±2.54, including 32 cases of NLR≥4.5 and 80 cases〈4.5. Differences of NLR was statistical significant among age, tumor stage, serum ALB and LDH groups, respectively （All P〈0.05）. Lower NLR patients demonstrated short- ened overall survival time than that of higher NLR patients （Median survival time 17 months vs 10 months, xz = 13. 043, Log-Rank P=0. 000）. Multi-variate analyses showed NLR, age and tumor stage are independent prognostic factors for SCLC patients （HR 1. 658, 95% CI 1. 036-2. 653 P=0. 035, HR.. 1. 795, 95〈CI： 1. 163-2. 771, P=0. 008, and HR：2. 535, 95%CI.. 1. 523-4. 220, P〈0. 000, respectively）. Conclusions NLR at diagnosis could be useful for evaluating prognosis for SCLC patients.

关 键 词：小细胞肺癌 中性粒细胞淋巴细胞比值 预后 

分 类 号：R734.2[医药卫生—肿瘤]