术前NLR-PLR评分或可帮助预测UTUC患者预后  

Preoperative NLR-PLR may help to predict the prognosis of UTUC patients

作　　者：董锦泰 邱学德[1] 和术臣[1] 何进[1] 杨晓芳[1] DONG Jintai;QIU Xuede;HE Shuchen;HE Jin;YANG Xiaofang(Department of Urology,The Second Affiliated Hospital of Kunming Medical University,Kunming 650000,China)

机构地区：[1]昆明医科大学第二附属医院泌尿外科,云南昆明650000

出　　处：《现代泌尿外科杂志》2023年第11期952-956,共5页Journal of Modern Urology

摘　　要：目的本研究拟探讨术前外周血中血小板/淋巴细胞比值(PLR)、中性粒细胞/淋巴细胞比值(NLR)两者构成的联合评分NLR-PLR对接受根治性手术治疗的上尿路上皮癌(UTUC)患者预后的预测效用。方法收集并整理昆明医科大学第二附属医院泌尿外科2015年1月—2020年12月收治的104例行根治性肾盂输尿管切除术+膀胱袖状切除术且经术后病理证实为UTUC患者完整的临床资料及术后随访资料。根据患者的NLR、PLR值绘制ROC曲线,计算出NLR、PLR的最佳截断值,并根据截断值设置NLR-PLR评分,将患者分为NLR-PLR“1”分组(PLR≥161.46且NLR≥2.51)和NLR-PLR“0”分组(剩余患者)。组间比较采用卡方检验,并运用Kaplan-Meier法绘制生存曲线,根据Cox回归分析模型中的单、多因素风险回归模型,得出接受根治性手术治疗的UTUC患者总生存率(OS)缩短的危险因素。结果PLR、NLR的最佳截断值分别为161.46和2.51,NLR-PLR“0”分组共74例患者,NLR-PLR“1”分组共30例患者。Cox多因素回归分析表明T分期、肿瘤最大径、NLR-PLR评分是缩短UTUC患者OS的独立危险因素(P<0.05)。结论术前NLR-PLR评分有望成为UTUC患者预后的潜在预测指标,NLR-PLR评分越高,UTUC患者不良预后的可能性越大。Objective To investigate the predictive value of preoperative platelet/lymphocyte ratio(PLR)and neutrophil/lymphocyte ratio(NLR)(NLR-PLR)in peripheral blood for the prognosis of patients with upper urinary tract urothelial carcinoma(UTUC)undergoing radical surgery.Methods The clinical data of 104 UTUC patients who underwent radical nephroureterectomy plus bladder sleeve resection in our hospital during Jan.2015 and Dec.2020 were retrospectively analyzed.The receiver operating characteristic(ROC)curve was drawn according to NLR and PLR,the optimal cut-off values of NLR and PLR were calculated,and NLR-PLR was determined accordingly.The patients were divided into NLR-PLR group 1(PLR≥161.46 and NLR≥2.51)and NLR-PLR group 0(remaining patients).Chi-square test was used for comparison between groups,and the Kaplan-Meier method was used to draw survival curves.According to the Cox univariate and multivariate risk regression models,the risk factors for decreased overall survival(OS)were determined.Results The optimal cut-off values of PLR and NLR were 161.46 and 2.51,respectively.There were 74 patients in the NLR-PLR group 0 and 30 in the NLR-PLR group 1.Cox multivariate regression analysis showed that T stage,maximum tumor diameter and NLR-PLR were independent risk factors for reduced OS(P<0.05).Conclusion Preoperative NLR-PLR is a potential predictor of the prognosis of UTUC patients.Higher NLR-PLR is associated with poorer prognosis.

关 键 词：血小板/淋巴细胞比值 中性粒细胞/淋巴细胞比值 上尿路上皮癌 预后 

分 类 号：R737.1[医药卫生—肿瘤]