NLR、PLR对接受根治性同步放化疗的局部晚期头颈部肿瘤病人的生存预测价值

万强琨; 何斌; 李婷婷; 江浩

doi:10.13898/j.cnki.issn.1000-2200.2023.09.011

NLR、PLR对接受根治性同步放化疗的局部晚期头颈部肿瘤病人的生存预测价值

Prognostic value of NLR and PLR on the survival of patients with locally advanced head and neck cancer treated with radical concurrent chemoradiotherapy

摘要

摘要:
目的分析头颈部肿瘤病人接受根治性同步放化疗之前的外周血中性粒细胞与淋巴细胞比值(neutrophil to lymphocyte ratio, NLR)、血小板与淋巴细胞比值(platelet to lymphocyte ratio, PLR)对于病人总生存期(overall survival，OS)的影响。
方法回顾性分析205例接受根治性同步放化疗的头颈部肿瘤病人，分析NLR、PLR对病人OS的影响，探讨与病人OS有关的影响因素。
结果运用二元logistic回归分析，证明病人治疗前NLR、PLR均明显影响病人OS(P < 0.01)。通过ROC曲线算出NLR、PLR的截断值：NLR=2.554(AUC=0.732，P < 0.01)，PLR=213.931(AUC=0.780, P < 0.01)。根据截断值将病人分为NLR^high、NLR^low、PLR^high、PLR^low 4组。生存分析结果显示，NLR^low及NLR^high病人OS分别为44(42, 46)个月及31(28，34)个月，组间比较差异有统计学意义(χ²=39.93，P < 0.01)；PLR^low及PLR^high病人OS分别为44(42, 46)个月及34(31, 37)个月，组间比较差异有统计学意义(χ²=24.36，P < 0.01)。单因素分析结果显示：NLR、PLR、肿瘤原发部位、肿瘤病理类型等因素与病人OS相关(P < 0.05~P < 0.01)。多因素分析结果显示：NLR、PLR、肿瘤病理类型等因素与病人OS相关(P < 0.05~P < 0.01)。
结论NLR、PLR是头颈部肿瘤病人OS的独立影响因素，治疗前NLR、PLR更低的病人生存时间更长。

Abstract:
ObjectiveTo analyze the effects of neutrophil to lymphocyte ratio(NLR) and platelet to lymphocyte ratio(PLR) on the overall survival(OS) in patients with head and neck cancer before radical concurrent chemoradiotherapy.
MethodsThe clinical data of 205 patients with head and neck tumors treated with radical concurrent chemoradiotherapy were retrospectively analyzed.The effects of NLR and PLR on OS were analyzed, and the influencing factors related to patient OS were investigated.
ResultsThe results of binary logistic regression showed that the NLR and PLR significantly affected OS before treatment(P < 0.01).The cutoff values of NLR and PLR were calculated by ROC curve: the NLR was 2.554(AUC=0.732, P < 0.01), and the PLR was 213.931(AUC=0.780, P < 0.01).The patients were divided into the NLR^high, NLR^low, PLR^high and PLR^low groups according to the cutoff values.The results of survival analysis showed that the OS of NLR^low and NLR^high groups were 44(42, 46) months and 31(28, 34) months, respectively, and the difference of which was statistically significant between two groups (χ²=39.93, P < 0.01);the OS of PLR^low and PLR^high groups were 44(42, 46) months and 34(31, 37) months, respectively, and the difference of which was statistically significant between two groups (χ²=24.36, P < 0.01).The results of univariate analysis showed that the NLR, PLR, tumor primary site and tumor pathological type were related to the OS of patients(P < 0.05 to P < 0.01).The results of multivariate analysis showed that the NLR, PLR and pathological type were related to the OS of patients (P < 0.05 to P < 0.01).
ConclusionsThe NLR and PLR are the independent influencing factors of OS in patients with head and neck tumors, and the patients with lower NLR and PLR before treatment have longer survival time.

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