中性粒细胞与淋巴细胞比值对鼻咽癌放射敏感性及预后影响的研究  

Influence of neutrophil-lymphocyte ratio on radiosensitivity and prognosis in patients with nasopharyngeal carcinoma

作　　者：李晓惠[1,2,3] 徐冰清[1,4] 高劲[1,5] 夏云飞[1,2] 

机构地区：[1]华南肿瘤学国家重点实验室,广州510060 [2]中山大学肿瘤防治中心放疗科,广州510060 [3]解放军第四二一医院肿瘤科,广州510318 [4]宜昌市中心人民医院肿瘤科,443003 [5]安徽省肿瘤医院放疗科,合肥230031

出　　处：《中华放射肿瘤学杂志》2016年第5期432-436,共5页Chinese Journal of Radiation Oncology

基　　金：863课题（2006AA022484）;国家自然科学基金（30070237）

摘　　要：目的观察中性粒细胞与淋巴细胞比值（NLR）对鼻咽癌放射敏感性及预后影响，探讨其与临床特征之间关系和意义。方法2006—2011年于中山大学肿瘤防治中心收治的初诊鼻咽癌患者266例入组。分析疗前NLR与放疗剂量20、40、60Gy及放疗结束后3个月时鼻咽癌疗效关系，及对鼻咽癌患者OS、LRF、DMF率的影响。Kaplan—Meier法计算并Logrank法检验。结果在不同T分期、性别之间，NLR不同（P=0．039、0．032）。NLR≤3患者OS、LRF、DMF率均明显高于NLR〉3者（P=0．004、0．025、0．045）。随着NLR逐渐升高鼻咽癌患者放疗敏感性逐渐降低，较敏感组和中等敏感组差异显著（P=0．043）。在放疗剂量为40Gy时，肿瘤消退组NLR较肿瘤残余组低（P=0．025）。结论鼻咽癌患者疗前NLR升高是影响预后的不利因素，NLR为鼻咽癌预后评估提供了简单实用的方法。Objective To investigate the influence of neutrophil-lymphocyte ratio （NLR） on radiosensitivity and prognosis, the relationship between NLR and clinical features, and the clinical value of NLR in patients with nasopharyngeal carcinoma （NPC）. Methods 2006 to 2011 in the cancer center of Zhongshan University admitted to the newly diagnosed nasopharyngeal cancer patients in 266 cases. The association of pretreatment NLR with radiotherapy doses 20, 40, and 60 Gy and therapeutic effect at 3 months after radiotherapy was analyzed, as well as the influence of NLR on overall survival （ OS ） , local recurrence-free （LRF）, and distant metastasis-free （DMF） rates. The Kaplan-Meier method was used to calculate survival rates and the log-rank test was used for survival difference analysis. Results NLR showed differences across patients with different T stages and sexes （P = 0. 039,0. 032）. The patients with NLR ≤ 3 had significantly higher OS, LRF, and DMF rates compared with those with NLR〉3 （P= 0. 004 , 0. 025 , 0. 045）. As NLR increased, the radiosensitivity in patients with NPC was reduced gradually, and radiosensitivity showed a significant difference between sensitive group and moderately sensitive group （P = 0. 043 ）. When the radiotherapy dose was 40 Gy, the tumor regression group had a lower NLR than the residual tumor group （P=0. 025）. Conclusions In patients with NPC, an increased pretreatment NLR is an adverse prognostic factor, and NLR can be used as a simple and convenient method to evaluate the prognosis of patients with NPC.

关 键 词：中性粒细胞与淋巴细胞比值 鼻咽肿瘤 放射敏感性 预后 

分 类 号：R739.63[医药卫生—肿瘤]