放疗前NLR和PLR对局部晚期鼻咽癌患者预后的影响  

Effect of NLR and PLR from pre-radiotherapy on prognosis of locally advanced nasopharyngeal carcinoma patients

作　　者：杨丽萍[1] 吴爱林[1] 周燕[1] 陶振超 何健 杨婧 张洋洋[1] 钱立庭 高劲 YANG Li-ping;WU Ai-lin;ZHOU Yan;TAO Zhen-chao;HE Jian;YANG Jing;ZHANG Yang-yang;QIAN Li-ting;GAO Jin(Department of Head and Neck Radiotherapy,the First Affiliated Hospital of USTC,Division of Life Sciences and Medicine,University of Science and Technology of China,Hefei,Anhui 230031,China)

机构地区：[1]中国科学技术大学附属第一医院头颈放疗科,安徽合肥230031

出　　处：《中华全科医学》2022年第9期1458-1461,1534,共5页Chinese Journal of General Practice

基　　金：国家自然科学基金青年科学基金项目(11805198)。

摘　　要：目的 探讨放疗前血液中性粒细胞与淋巴细胞比值(neutrophil-to-lymphocyte ratio,NLR)及血小板与淋巴细胞比值(platelet-lymphocyte ratio,PLR)与局部晚期鼻咽癌放疗患者预后的相关性。方法 回顾性分析2016年1月—2018年12月在中国科学技术大学附属第一医院头颈放疗科行放化疗的60例局部晚期鼻咽癌患者临床资料及随访资料,采用ROC曲线确定NLR和PLR的最佳截断值,并据此分为高水平组和低水平组。采用χ2检验或Fisher精确检验比较组间差异,使用Kaplan-Meier法绘制生存曲线,采用Cox回归模型进行多因素分析。结果依据ROC曲线,放疗前NLR和PLR的最佳截取值分别为1.99、154.94。在单因素分析中N分期、临床分期、放疗前NLR及PLR与患者预后相关(均P<0.05);放疗前低NLR组的生存时间为(62.26±1.88)个月,优于放疗前高NLR组[(51.17±3.94)个月,P=0.048];相较于放疗前高PLR组,放疗前低PLR组生存时间更长(P=0.014);而Cox多因素分析中临床分期、N分期、放疗前PLR水平是影响局部晚期鼻咽癌患者生存的独立预后因素(均P<0.05)。结论 放疗前PLR水平可作为局部晚期鼻咽癌放疗患者独立预后预测因子,推荐其作为辅助手段参与患者预后评估。Objective To explore the correlation between neutrophil-to-lymphocyte ratio(NLR)and platelet-lymphocyte ratio(PLR)and the prognosis of patients with locally advanced nasopharyngeal carcinoma undergoing radiotherapy.Methods We retrospectively analysed the clinical data and follow-up data of 60 patients with locally advanced nasopharyngeal carcinoma who underwent radiotherapy and chemotherapy from January 2016 to December 2018.An ROC curve was used to determine NLR and PLR.According to the best cutoff value,patients were divided into high-and low-level groups.Chi-square or Fisher exact test was used to compare the differences between groups.Kaplan-Meier method was used to draw survival curve.Cox regression model was used for univariate and multivariate analysis.Results According to the ROC curve,the best cutoff values of NLR and PLR before radiotherapy were 1.99 and 154.94,respectively.In univariate analysis,N stage,clinical stage,pre-radiotherapy NLR and PLR were related to patient prognosis(all P<0.05).The average survival time of the low pre-radiotherapy NLR group was(62.26±1.88)months,which was better than that of the high NLR group of(51.17±3.94)months(P=0.048).Compared with the high pre-radiotherapy PLR group,the average survival time of the low PLR group was longer(P=0.014).Cox multivariate analysis showed that clinical stage,N stage,and pre-radiotherapy PLR level were independent prognostic factors for patient survival(all P<0.05).Conclusion PLR before radiotherapy could be used as an independent prognostic predictor for patients with locally advanced nasopharyngeal carcinoma undergoing radiotherapy.It is recommended as an auxiliary method for evaluating the prognosis of patients.

关 键 词：局部晚期鼻咽癌 中性粒细胞与淋巴细胞比值 血小板与淋巴细胞比值 预后 

分 类 号：R739.2[医药卫生—肿瘤] R730.7[医药卫生—临床医学]