术前血液中性粒细胞与淋巴细胞比值作为上皮性卵巢癌的独立预后预测因子

Zhang Zhang, Q. Hao
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引用次数: 2

摘要

目的:本研究旨在评估术前中性粒细胞与淋巴细胞比值(NLR)升高对上皮性卵巢癌(EOC)剖腹综合分期或最佳减瘤手术后预后的影响,并确定NLR作为独立预后预测指标的价值。方法:本研究选择80例原发性EOC患者,手术时具有完整的临床和病理资料。通过受试者操作特征(receiver operator characteristic, ROC)曲线确定术前NLR的最佳临界值,并将患者分为低NLR组和高NLR组。单因素和多因素分析评估术前NLR患者接受全面分期剖腹手术或最佳肿瘤减容手术的预后效果。免疫组织化学检测CD68的表达水平。结果:NLR的最佳临界值为3.8。术前低NLR组(NLR≤3.8)与高NLR组(NLR >3.8) FIGO期NLR差异有统计学意义,其他参数差异无统计学意义。平均随访45个月,术后1年、3年生存率分别为93.7%、60.0%。术前NLR > 3.8和分期Ⅲ/Ⅳ均为总生存率和无病生存率差的危险因素。多因素分析显示,NLR高(P<0.05)、Ⅲ/Ⅳ分期高(P<0.05)的患者总生存期较差具有预后意义。高NLR组cd68阳性肿瘤相关巨噬细胞数量显著高于低NLR组(分别为54.65±8.78和41.78±9.10);P < 0.001)。结论:术前NLR升高提示EOC患者预后不良。术前NLR可能是EOC患者重要的独立预后因素。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Preoperative blood neutrophil to lymphocyte ratio as an independent prognostic predictor for epithelial ovarian cancer
Objective: This study aims to evaluate the effect of an elevated preoperative neutrophil to lymphocyte ratio (NLR) on outcome after comprehensive staging laparotomy or optimal tumor debulking surgery for epithelial ovarian cancer (EOC) and determine the value of the NLR as an independent prognostic prediction marker. Methods: A total of 80 women with primary EOC and with complete clinical and pathological information documented at the time of surgery were selected for this study. The optimum cut-off value of the preoperative NLR was identified through receiver operator characteristic (ROC) curve, and the patients were then classified into two groups: low and high NLR group. Univariate and multivariate analyses were performed to assess the prognostic effect of the preoperative NLR patients who underwent comprehensive staging laparotomy or optimal tumor debulking surgery. The levels of expression of CD68 were measured through immunohistochemistry. Results: The optimal cut-off value of the NLR was 3.8. The preoperative NLR differed significantly in the FIGO stage between the low NLR group (NLR ≤3.8) and the high NLR group (NLR >3.8), but no discrimination was observed in other parameters. The mean follow-up time was 45 months, and the post-operative 1- and 3-year survival rates were 93.7% and 60.0%, respectively. The preoperative NLR > 3.8 and stage Ⅲ/Ⅳ were all risk factors for poor overall and disease-free survival. Multivariate analysis revealed the patients with high NLR (P<0.05) and stage Ⅲ/Ⅳ (P<0.05) had prognostic significance for poor overall survival. The number of CD68-positive tumor-associated macrophages was significantly higher in the high NLR group than in the low NLR group (54.65±8.78 and 41.78±9.10, respectively; P<0.001). Conclusion: An elevated blood preoperative NLR indicates poor prognosis in patients with EOC. Preoperative NLR may function as an important independent prognostic factor for patients with EOC.
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