外周血和尿常规炎性指标评估PD-1抑制剂治疗晚期尿路上皮癌预后的价值  

The prognostic value of peripheral blood and urinary routine inflammatory markers in patients with advanced urothelial carcinoma treated with PD-1 inhibitors

作　　者：郝超[1] 艾海涛 钟华明 徐志豪 黄骥[1] 涂新华[1] HAO Chao;AI Haitao;ZHONG Huaming;XU Zhihao;HUANG Ji;TU Xinhua(Department of Urology,Jiangxi Cancer Hospital/The Second Affiliated Hospital of Nanchang Medical College,Jiangxi Nanchang 330029,China.)

机构地区：[1]江西省肿瘤医院/南昌医学院第二附属医院泌尿外科,江西南昌330029

出　　处：《现代肿瘤医学》2024年第15期2807-2812,共6页Journal of Modern Oncology

基　　金：江西省卫生健康委科技计划项目(编号:202211019)。

摘　　要：目的:探讨血小板与白细胞比值(platelet and white blood cells ratio, PWR)、血小板与淋巴细胞比值(platelet and lymphocyte ratio, PLR)、中性粒细胞与淋巴细胞比值(neutrophil to lymphocyte ratio, NLR)以及尿白细胞计数(urinary leucocyte count, ULEU)与接受PD-1抑制剂治疗晚期尿路上皮癌(urothelial carcinoma, UC)患者预后的关系。方法:收集78例接受PD-1抑制剂治疗晚期UC患者的临床资料,利用Kaplan-Meier法计算生存率和Log-rank检验比较不同组间的生存差异,同时采用COX回归分析预后影响因素。结果:低PLR组与高PLR组的1年生存率分别为71.98%和47.63%,差异有统计学意义(P<0.05);低NLR组与高NLR组的1年生存率分别为71.36%和48.15%,差异有统计学意义(P<0.05);PWR高低两组和ULEU状态预测UC患者生存率无显著性差异(P>0.05)。单因素回归分析结果显示,N分期、M分期、TNM分期、远处转移个数、PLR、NLR是影响晚期UC患者生存情况的危险因素(P<0.05)。多因素回归分析显示,PLR是影响接受PD-1抑制剂治疗的UC患者预后的独立因素。结论:PLR、NLR为影响接受PD-1抑制剂治疗晚期UC患者预后的独立因素,PLR高值组和NLR高值组患者的预后较PLR低值组和NLR低值组的患者差。Objective:To investigate the relationship between platelet and white blood cells ratio(PWR),platelet and lymphocyte ratio(PLR),neutrophil to lymphocyte ratio(NLR),the urinary leucocyte count(ULEU)and prognosis of patients with advanced urothelial carcinoma(UC)treated with PD-1 inhibitors.Methods:Clinical data of 78 patients with advanced urothelial carcinoma(UC)treated with PD-1 inhibitor were collected,survival rate was calculated by Kaplan-Meier method,Log-rank test was used to compare the differences of survival between different groups,and prognostic factors were analyzed by COX regression analysis.Results:The 1-year survival rates of low PLR group and high PLR group were 71.98%and 47.63%,respectively,with statistically significant differences(P<0.05).The 1-year survival rates of the low NLR group and the high NLR group were 71.36%and 48.15%,respectively,with statistically significant differences(P<0.05).The high PWR group and low PWR group,as well as the status of ULEU,did not demonstrate a significant difference in their ability to predict the survival of patients with UC(P>0.05).Univariate regression analysis revealed that N stage,M stage,TNM stage,number of distant metastasis,PLR and NLR were identified as significant risk factors impacting the survival outcomes of patients with advanced UC( P <0.05).Multivariate regression analysis showed that PLR was an independent factor affecting the prognosis of UC patients treated with PD-1 inhibitors. Conclusion: PLR and NLR are independent factors affecting the prognosis of UC patients.The prognosis of patients with high PLR and high NLR is worse than that of patients with low PLR and low NLR.

关 键 词：尿路上皮癌 预后 PD-1抑制剂 血小板 白细胞 

分 类 号：R737[医药卫生—肿瘤]