中性粒细胞和淋巴细胞比值对根治性前列腺切除术患者生化复发的影响  

Effect of neutrophil-to-lymphocyte ratio on the biochemical recurrence in patients treated with radical prostatectomy

作　　者：侯佩先 金坤 邱实[2,3] 王亚萍 农开磊 郑筱男 杨璐[2] 魏强[2] HOU Pei-xian;JIN Kun;QIU Shi;WANG Ya-ping;NONG Kai-lei;ZHENG Xiao-nan;YANG Lu;WEI Qiang(West China School of Medicine,West China Hospital,Sichuan University,Chengdu 610041,China;Institute of Urology,Department of Urology,West China Hospital,West China Hospital,Sichuan University,Chengdu 610041,China;Center of Biomedical Big Data,West China Hospital,Sichuan University,Chengdu 610041,China)

机构地区：[1]四川大学华西临床医学院,四川成都610041 [2]四川大学华西医院泌尿外科,四川成都610041 [3]四川大学华西医院生物医学大数据中心,四川成都610041

出　　处：《现代泌尿外科杂志》2020年第5期392-396,共5页Journal of Modern Urology

摘　　要：目的探究接受根治性前列腺切除术治疗的患者,其中性粒细胞和淋巴细胞比值(NLR)与生化复发(BCR)的关系。方法回顾性收集2009年1月至2017年12月于四川大学华西医院接受根治性前列腺切除术(RP)的620例前列腺癌患者的临床资料。运用单因素与多因素Cox回归分析、限制性3次样条回归分析和趋势性检验分析NLR与BCR的关系,用分层分析进一步讨论手术入路、肿瘤大小和前列腺特异性抗原(PSA)水平对NLR与BCR关系的影响。结果术前升高的NLR不会导致BCR(P=0.31)。然而,亚组分析显示,在中等PSA水平组中,升高的NLR可导致BCR风险增加(HR=1.12,95%CI:1.04~1.20,P=0.04)。在经腹腔入路手术的患者中,较高的NLR更容易导致BCR(HR=1.05,95%CI:0.99~1.11,P=0.02)。对于那些肿瘤体积中等(HR=1.06,95%CI:0.93~1.20,P=0.03)或较大(HR=1.02,95%CI:0.94~1.10,P=0.03)的患者,BCR风险可随着NLR的升高而增加。结论对于经腹腔入路手术、肿瘤大小中等或较大、中等PSA水平的患者,生化复发风险与NLR呈正相关。Objective To explore the association between biochemical recurrence(BCR)and neutrophil-to-lymphocyte ratio(NLR)in patients with prostate cancer(PCa)after radical prostatectomy(RP).Methods Clinical data of 620 PCa patients treated with RP during Jan.2009 and Dec.2017 were retrospectively analyzed.The association between NLR and BCR was analyzed with Cox proportional hazards regression models,restricted-cubic spline regressions and tests for trend.The effects of surgical approach,tumor size and prostate specific antigen(PSA)level on the association between NLR and BCR were analyzed with subgroup analyses.Results Elevated preoperative NLR did not lead to BCR(P=0.31).Subgroup analyses showed that among patients with intermediate PSA level,higher NLR resulted in higher BCR risk(HR=1.12,95%CI:1.04-1.20,P=0.04).In patients who adopted transperitoneal route,higher NLR led to higher BCR risk(HR=1.05,95%CI:0.99-1.11,P=0.02).In patients with intermediate tumor size(HR=1.06,95%CI:0.93-1.20,P=0.03)or large tumor size(HR=1.02,95%CI:0.94-1.10,P=0.03),higher NLR was associated with higher BCR risk.Conclusion BCR risk was positively associated with NLR in patients who adopted transperitoneal route,with intermediate or large tumor size and intermediate PSA level.

关 键 词：前列腺癌 中性粒-淋巴细胞比例 生化复发 根治性前列腺切除术 

分 类 号：R737.2[医药卫生—肿瘤]