淋巴细胞与C反应蛋白比值与非小细胞肺癌患者预后关系  

The relationship between lymphocyte-to-C-reactive protein ratio and prognosis in patients with non-small cell lung cancer

作　　者：刘研 彭思敏 杨金荣 张玉松[4] 陈国崇[1] 秦立强[1] Liu Yan;Peng Simin;Yang Jinrong;Zhang Yusong;Chen Guochong;Qin Liqiang(School of Public Health,Suzhou Medical College of Soochow University,Suzhou 215123,Jiangsu,China;Preventive Medicine Department,Dongguan People's Hospital,Dongguan 523000,Guangdong,China;Health Department,Wu Zhong District Disease Prevention and Control Center,Suzhou 215123,Jiangsu,China;Oncology Department,Second Afiliated Hospital of Soochow University,Suzhou 215123,Jiangsu,China)

机构地区：[1]苏州大学苏州医学院公共卫生学院,江苏苏州215123 [2]广东省东莞市人民医院预防保健科,广东东莞523000 [3]苏州市吴中区疾病预防控制中心卫生科,江苏苏州215123 [4]苏州大学附属第二医院肿瘤科,江苏苏州215123

出　　处：《肿瘤代谢与营养电子杂志》2024年第5期651-658,共8页Electronic Journal of Metabolism and Nutrition of Cancer

摘　　要：目的探讨淋巴细胞与C反应蛋白比值(LCR)在非小细胞肺癌(NSCLC)患者预后中的价值。方法选取2016年1月至2019年10月苏州大学附属第一医院和苏州大学附属第二医院肿瘤科和呼吸科确诊NSCLC的患者422例,以结果为导向的方法确定最合适的LCR截断点,将患者分为高LCR组与低LCR组。Kaplan-Meier法构建生存曲线,Log-rank检验评估组间差异,并根据肿瘤组织学类型(鳞癌和腺癌)以及TNM分期(Ⅰ~Ⅲ期和Ⅳ期)进行分层分析。使用Cox比例风险回归模型计算风险比(HR)和95%CI。此外,根据患者特征进行亚组分析和交互作用分析,Cox相乘交互作用分析患者不同特征与LCR的交互作用对NSCLC患者预后的影响。结果Kaplan-Meier分析显示,高LCR患者总生存率显著升高(P<0.001);按肿瘤组织学类型及TNM分期分层后,高LCR的患者总生存期仍显著增加(P<0.001)。多因素Cox比例风险回归模型分析显示,与低LCR比较,高LCR组(HR=0.45,95%CI=0.34~0.61,P<0.001)患者的预后良好;性别(P=0.012)、吸烟(P=0.002)及组织学类型(P=0.012)与LCR存在交互作用,即高LCR是男性、曾经/目前吸烟者、鳞癌或腺癌患者预后良好的指标。结论高LCR水平与NSCLC患者预后良好有关,LCR可作为预测NSCLC患者预后稳定且有用的生物标志物。Objective Systemic inflammatory response is closely related to tumor progression.We aimed to investigate the prognostic value of ratio of lymphocyte to C-reactive protein ratio(LCR)for overall survival(OS)in patients with non-small cell lung cancer(NSCLC).Method 422 NSCLC patients were enrolled in this study.An outcome-oriented Method was used to determine the most appropriate cut-off value of LCR.The participants were divided into two groups:a low-LCR group and a high-LCR group.Survival curves were generated using the Kaplan-Meier Method and compared using the log-rank test.We performed subgroup analysis according to histological type(adenocarcinoma vs squamous cell carcinoma),and TNM stage(Ⅰ-ⅢvsⅣ).Cox proportional hazard regression model was used to calculate hazard ratio(HR)and 95%confidence interval(CI).Moreover,We performed subgroup analysis and interaction analysis based on patient characteristics,and Cox product interaction analysis to investigate the impact of the interaction between patient characteristics and LCR on the prognosis of NSCLC patients.Result The Kaplan-Meier analysis revealed that patients with high LCR had significantly improved OS(P<0.001).Patients with high LCR also showed a significantly improved OS(P<0.001)after stratified by histological type and TNM stage.The Cox multivariate analysis showed that patients with high LCR(HR=0.45,95%CI=0.34-0.61,P<0.001)had favorable prognoses when compared with those with the lowest LCR.Gender(P=0.012),smoking(P=0.002),and histological type(P=0.012)significantly interacted with LCR,indicating that high LCR was a good indicator for male,former/current smokers,squamous carcinoma or adenocarcinoma patients.Conclusion High LCR may be associated with a favorable prognosis in NSCLC patients.

关 键 词：淋巴细胞与C反应蛋白比值 非小细胞肺癌 总生存率 炎症 生物标志物 预后 亚组分析 交互作用 

分 类 号：R734.2[医药卫生—肿瘤]