术前中性粒细胞与淋巴细胞比值对睾丸生殖细胞肿瘤预后的预测价值  

The predictive value of preoperative neutrophil to lymphocyte ratio for the prognosis of testicular germ cell tumors

作　　者：李宗阳 张志磊 祝涛 吴玉书 郭志凡 臧运江[2] LI Zongyang;ZHANG Zhilei;ZHU Tao;WU Yushu;GUO Zhifan;ZANG Yunjiang(School of Clinical Medicine,Shandong Second Medical University,Shandong Weifang 261041,China;Department of Urology,Weifang People's Hospital,Shandong Weifang 261041,China)

机构地区：[1]山东第二医科大学临床医学院,山东潍坊261041 [2]潍坊市人民医院泌尿外科,山东潍坊261041

出　　处：《现代肿瘤医学》2024年第18期3519-3525,共7页Journal of Modern Oncology

摘　　要：目的:探讨术前中性粒细胞与淋巴细胞比值(neutrophil to lymphocyte ratio,NLR)对睾丸生殖细胞肿瘤(testicular germ cell tumors,TGCT)患者预后的预测价值。方法:收集2016年01月至2023年10月于潍坊市人民医院行睾丸根治术的TGCT患者的临床及随访资料。通过受试者工作特征曲线(ROC)确定NLR的最佳截断值,用Kaplan-Meier法绘制生存曲线,比较高、低NLR组间的癌症特异性生存率(CSS)和无进展生存率(PFS)差异。采用Cox比例风险模型筛选影响CSS和PFS的独立危险因素。结果:共纳入33例患者,包括21例(63.6%)精原细胞瘤和12例(36.4%)非精原细胞瘤。Kaplan-Meier分析结果表明:高NLR预示着更差的CSS(P<0.001)和PFS(P<0.001)。Cox多因素分析显示:高NLR(HR=18.225,95%CI:1.806~183.859,P=0.014)是CSS的独立预后危险因素;高NLR(HR=11.371,95%CI:1.751~73.847,P=0.011)也是PFS的独立预后危险因素。结论:术前NLR高值是影响TGCT患者预后的独立预后危险因素,NLR越高患者的CSS和PFS越差。Objective:To investigate the predictive value of preoperative neutrophil to lymphocyte ratio(NLR)for the prognosis of patients with testicular germ cell tumors(TGCT).Methods:Collect clinical and follow-up data of TGCT patients who underwent testicular radical surgery at Weifang People's Hospital from January 2016 to October 2023.Determine the optimal cut-off value of NLR through receiver operating characteristic curve(ROC),and plot the survival curve using Kaplan-Meier analysis to compare the differences in cancer specific survival(CSS)and progression-free survival(PFS)between high and low NLR groups.Cox proportional hazards model was used to screen independent risk factors affecting CSS and PFS.Results:33 patients were included,including 21 cases(63.6%)of seminomatous germ cell tumor(SGCT)and 12 cases(36.4%)of non-seminomatous germ cell tumor(NSGCT).The Kaplan-Meier analysis results indicated that high NLR indicated poorer CSS(P<0.001)and PFS(P<0.001).Cox regression results showed that high NLR(HR=18.225,95%CI:1.806~183.859,P=0.014)was an independent risk factor for CSS.High NLR(HR=11.371,95%CI:1.751~73.847,P=0.011)was also an independent risk factor for PFS.Conclusion:High preoperative NLR is an independent risk factor affecting the prognosis of TGCT patients,and the higher the NLR,the worse the CSS and PFS of patients.

关 键 词：睾丸生殖细胞肿瘤 中性粒细胞与淋巴细胞比值 癌症特异性生存期 无进展生存期 

分 类 号：R737.21[医药卫生—肿瘤]