术前PLR联合NLR检测在肺癌预后评估中的价值  

The value of preoperative PLR and NLR in the prognostic evaluation of lung cancer

作　　者：上官子妍 陈琪[1] 姜敏[2] 胡凯文[2] SHANGGUAN Zi-yan;CHEN Qi;JIANG Min;HU Kai-wen(Beijing University of Chinese Medicine,Beijing 100029,China;Dongfang Hospital,Beijing University of Chinese Medicine,Beijing 100078,China)

机构地区：[1]北京中医药大学,北京100029 [2]北京中医药大学东方医院,北京100078

出　　处：《海南医学院学报》2022年第3期198-203,208,共7页Journal of Hainan Medical University

基　　金：国家重点研发计划项目(2018YFC1705100);中央高校基本科研业务专项北京中医药大学重点攻关项目(2020-JYB-ZDGG-123);中医药治未病健康工程专项经费北京市经开区中医治未病健康管理技术优化方案。

摘　　要：目的:探究肺癌患者冷消融术前者血小板/淋巴细胞比值(PLR)以及中性粒细胞/淋巴细胞比值(NLR)与预后的关系。方法:回顾性分析2012年1月~2018年3月于本院行肺氩氦刀冷冻消融术的原发性肺癌患者的病例资料,根据患者术前1周内的血常规资料计算PLR及NLR值。对患者进行随访,随访截止日期为2021年6月,根据患者生存预后绘制受试者生存曲线(ROC曲线),计算约登指数确定PLR及NLR最佳临界值,并以此进行分组;分析术前PLR、NLR水平与原发性肺癌患者临床病理特征及预后生存时间的相关性。结果:根据ROC曲线计算最佳截点,分为高PLR组(PLR≥155.72,n=127)和低PLR组(PLR<155.72,n=87);高NLR组(NLR≥2.91,n=120)和低NLR组(NLR<2.91,n=94);术前高PLR、高NLR组的pT、pN、pM及TNM分期与低值组相比较,差异具有统计学意义(P<0.05);Cox多因素分析显示,高PLR、高NLR、高pT分期、高pM分期、高TNM分期是影响术后生存期的独立危险因素;高水平PLRNLR组的术后生存率较其他组显著降低,差异具有统计学意义(P<0.05)。结论:原发性肺癌患者术前NLR和PLT显著升高与不良预后相关;两者联合对评估患者术后生存期具有潜在的临床应用价值。Objective:To explore the relationship between platelet/lymphocyte ratio(PLR)and neutrophil/lymphocyte ra-tio(NLR)and prognosis of lung cancer patients before cold ablation.Methods:Retrospectively analyze The case data of primary lung cancer patients who underwent cryoablation of lung argon helium knife in our hospital from January 2012 to March 2018 were retrospectively analyzed.PLR and NLR were calculated based on the blood routine data of the patients within 1 week before the op-eration.Value.The patients were followed up.The deadline for follow-up was June 2021.The survival curve(ROC curve)was drawn according to the patient's survival prognosis,and the Youden index was calculated to determine the optimal cutoff value of PLR and NLR,and grouped based on this analysis.The correlation between pre-PLR level and NLR level and clinicopathological characteristics and prognostic survival time of patients with primary lung cancer was analyzed.Results:The best cut-off point was calculated according to the ROC curve and divided into the high PLR group(PLR≥155.72,n=127)and the low PLR group(PLR<155.72,n=87);high NLR group(NLR≥2.91,n=120)and low NLR group(NLR<2.91,n=94).In terms of preop-erative high PLR,high NLR group pT,pN,pM and TNM staging compared with low value group,the difference was statistical-ly significant(P<0.05);Cox multivariate analysis showed that high PLR,high NLR,high pT staging,high pM staging,and high TNM staging were independent risk factors affecting postoperative survival;the postoperative survival rate of the high-level PLRNLR group was significantly lower than that of the other groups,and the difference was statistically significant.Conclusion:The significant increase of NLR and PLT before operation in patients with primary lung cancer is associated with poor prognosis;the combination of the two has potential clinical application value in assessing the survival of patients after surgery.

关 键 词：肺肿瘤 PLR NLR 预后 总生存期 

分 类 号：R734.2[医药卫生—肿瘤]