治疗前PLR和NLR对鼻咽癌患者预后的影响

金龙; 付神波; 于娇

doi:10.3971/j.issn.1000-8578.2017.16.1536

治疗前PLR和NLR对鼻咽癌患者预后的影响

Effect of NLR and PLR from Pre-treatment on Prognosis of Nasopharyngeal Carcinoma Patients

摘要

摘要:
目的探讨鼻咽癌患者治疗前外周血中血小板与淋巴细胞比（platelet-lymphocyte ratio，PLR）、中性粒细胞与淋巴细胞比（neutrophil-lymphocyte ratio, NLR）与总生存期（overall survival, OS）、无进展生存期（progression-free survival, PFS）的相关性。
方法回顾性分析西安交通大学第一附属医院和陕西省人民医院2009年1月至2013年9月期间初治的91例鼻咽癌患者临床资料，根据ROC曲线选取PLR和NLR的截断值，将患者根据截断值分组，采用Kaplan-Meier法和Log rank检验比较不同组患者的总生存率和无进展生存率，应用Cox比例风险模型进行单因素和多因素分析。
结果当PLR=143.3、NLR=2.6时，对患者的预后预测价值最高。Cox多因素分析发现PLR≥143.3（RR=2.491, 95%CI=1.139~5.451, P=0.022）、NLR≥2.6（RR=2.186, 95%CI=1.021~4.682, P=0.044）时，患者的OS较短，而PLR≥143.3（RR=2.461，95%CI=1.242~4.874, P=0.01）时，患者的PFS较差。
结论治疗前PLR和NLR可能是影响鼻咽癌患者预后的独立危险因素。

Abstract:
Objective To investigate the correlation of platelet-to-lymphocyte ratio (PLR), neutrophil-to-lymphocyte ratio (NLR) in the peripheral blood of nasopharyngeal carcinoma patients before treatment with their overall survival (OS), progression-free survival (PFS).
Methods We retrospectively analyzed the clinical data of 91 nasopharyngeal carcinoma patients who received initial treatment in the First Affiliated Hospital of Xi'an Jiao Tong University and Shaanxi Provincial People's Hospital from January 2009 to September 2013. The patients were grouped on the basis of cutoff value of PLR and NLR according to ROC curve. Kaplan-Meier method and Log rank test were used to compare overall survival rates and progression free survival rates between different groups; meanwhile Cox proportional hazard model was used to analyze single factor and multiple factors.
Results When PLR=143.3 and NLR=2.6, the predictive value of patient's prognosis was the highest. Cox multivariate analysis showed that OS was shorter when PLR≥143.3 (RR=2.491, 95%CI=1.139-5.451, P=0.022) and NLR≥2.6(RR=2.186, 95%CI=1.021-4.682, P=0.044), and PFS was shorter when PLR≥143.3 (RR=2.461, 95%CI=1.242-4.874, P=0.01).
Conclusion PLR and NLR before treatment may be the independent risk factors for the prognosis of nasopharyngeal carcinoma patients.

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