外周血中性粒细胞与淋巴细胞比值和血小板与淋巴细胞比值评估神经母细胞瘤患者预后的价值  

Value of peripheral NLR and PLR in prediction of the survival of patients with neuroblastoma

作　　者：谢潭 杨合英[1] 侯广军[3] 耿宪杰[3] 张现伟[3] 张春英[1] 王家祥[1] 赵璇[2] 

机构地区：[1]郑州大学第一附属医院小儿外科,450000 [2]郑州大学第一附属医院生物细胞治疗中心,450000 [3]郑州市儿童医院小儿外科

出　　处：《中华普通外科杂志》2018年第2期122-125,共4页Chinese Journal of General Surgery

基　　金：河南省医学科技攻关计划资助项目（201702043）

摘　　要：目的探讨外周血中性粒细胞与淋巴细胞比值（neutrophil-to-1ymphocyteratio，NLR）和血小板与淋巴细胞比值（platelet—to—lymphocyteratio，PLR）对神经母细胞瘤患儿预后的预测价值。方法回顾性分析2010年10月至2013年12月郑州市儿童医院41例神经母细胞瘤患儿的临床资料，采用Kaplan—Meier、Log—rank检验、多因素COX回归分析神经母细胞瘤患儿的生存状况。结果病例组NLR和PLR均高于健康对照组（1．81±0．29比1．07±0．29，P〈0．01）、（169±23lzE76±3，P〈0．01）；年龄越大、临床分期越高、神经元烯醇化酶、24h尿香草扁桃酸值越高，NLR（x2=3．93、6．286、7．676、6．689，均P〈0．05）和PLR（x2=4．111、5．707、8．019、8．922，均P〈0．05）越高；LDH值越高，NLR越高（x2=7．769，P=0．02）。低NLR组3年生存率为84％，高NLR组为73％，差异有统计学意义（x2=4．002，P=0．045）；低NLR组3年无病生存率为74％，高NLR组为50％，差异有统计学意义（疋。=4．082，P=0．043）。低PLR组3年无病生存率为85％，高PLR组为38％，差异有统计学意义（x2=9．388，P=0．002）。肿瘤分期、MYCN基因表达、NLR为神经母细胞瘤患儿总体生存期的独立影响因素（P〈0．05）。结论NLR可有效预测神经母细胞瘤患儿的预后。Objective To investigate value of peripheral NLR and PLR for the survival of patients with neuroblastoma. Methods The clinical data of 41 neuroblastoma patients were analyzed by the Kaplan-Meier, Log-rank test, and multivariate COX regression. Results NLR, PLR levels of neuroblastoma patients were significantly higher than that in the healthy control group （ l. 81 ±0. 29 vs. 1.07 ±. 29, P 〈 0. 01 ） （ 169 ±23 vs. 76 ±3, P 〈 0. 01 ） ; The elder the age, the higher the clinical stages, the higher the serum levels of NSE, and urine VMA were, the higher was the NLR （X2 =3.93, 6. 286, 7. 676, 6. 689,all P〈0.05） and PLR （X2 =4.111, 5. 707, 8. 019, 8. 922, all P〈0.05）. The higher the serum level of LDH, the higher was the NLR （X2 =7. 769,P =0. 02）. 3-year overall survival in low NLR group was 84% and that in high NLR group was 73% （X2 =4. 002,P =0. 045） ; 3-year progression-free survival in low NLR group was 74% and that in high NLR group was 50% （X2 = 4. 082, P = 0. 043 ） ; 3-year progression-free survival of low PLR group was 85% and high PLR group was 38% （X2 =9. 388 ,P =0. 002）. The clinical stages, MYCN genetic expression, NLR levels were independent factors for the overall survial in patients with neuroblastoma （P 〈 0. 05 ）. Conclusion Pretreatment NLR level can effectively predict the prognosis of neuroblastoma.

关 键 词：神经母细胞瘤 淋巴细胞 血小板 存活率分析 

分 类 号：R749.4[医药卫生—神经病学与精神病学]