摘要
目的探讨初诊时外周血中性粒细胞与淋巴细胞比值(NLR)对非霍奇金淋巴瘤(NHL)患者预后的临床指导意义。方法选取武汉大学中南医院2013-01-10-2017-12-30收治的303例NHL患者作为研究对象,选取同期122名健康体检者作为对照。通过分析受试者工作特征(ROC)曲线,得出NLR最佳截取值为2.188,以2.188为界限将303例患者分为低NLR组(NLR<2.188,n=95)和高NLR组(NLR≥2.188,n=208),进一步应用统计学方法分析其与临床特征关系和在预后中的临床指导意义。结果 NLR与患者临床分期(r=0.129,P=0.026)和乳酸脱氢酶水平(r=0.253,P<0.001)呈低度正相关,与白蛋白(Alb)呈低度负相关(r=-0.134,P=0.020)。低NLR组5年总生存(OS)率和平均生存时间分别为(40.9±17.6)%和42.1个月,分别高于高NLR组的(35.5±6.0)%和33.6个月,χ^(2)=7.800,P=0.009。低NLR组5年无进展生存(PFS)率和平均生存时间分别为(44.3±11.5)%和39.3个月,分别高于高NLR组的(40.2±6.0)%和30.8个月,χ^(2)=6.700,P=0.010。单因素分析显示,免疫分型、临床分期、B症状、体能状态评分、国际预后指数评分、NLR值、绝对单核细胞计数(AMC)、LDH值、Alb值、合并贫血及β2微球蛋白值是影响NHL患者OS和PFS的因素,均P<0.05。多因素分析显示,临床分期(HR=1.651,P=0.040)、免疫表型(HR=2.022,P=0.040)是影响OS的独立因素,临床分期(HR=1.605,P=0.016)是影响PFS的独立因素。结论虽然多因素并未得出NLR是影响NHL患者OS或PFS的独立危险因素,但是单因素分析显示NLR在评估NHL患者的预后中仍然具有临床指导意义。
Objective To investigate the clinical significance of peripheral blood neutrophil to lymphocyte ratio(NLR)in the prognosis of patients with non-Hodgkin lymphoma(NHL)when initially diagnosed.Methods A total of 303 eligible NHL patients who were diagnosed in Zhongnan Hospital from January 10,2013 to December 30,2017 were enrolled in the study.Compared with 122 healthy individuals,the optimal cutoff value of NLR was 2.188 according to the ROC curve analysis.303 patients were divided into low NLR group(NLR<2.188,n=95)and high NLR group(NLR≥2.188,n=208).We further analyzed their relationship with clinical features and its impact on prognosis by statistical methods in303 patients.Results NLR had a positive relation with clinical stage(r=0.129,P=0.026)and lactic dehydrogenase(r=0.253,P<0.001),while NLR negative related with albumin(r=-0.134,P=0.020).The 5-year OS and mean survival time in the low NLR group were higher than those in the high NLR group[(40.9±17.6)% vs(35.5±6.0)%,42.1 months vs 33.6 months],respectively.The 5-year PFS and the mean survival time in the low NLR group were higher than those in the high NLR group annual PFS rate[(44.3±11.5)%vs(40.2±6.0)%,39.3 months vs 30.8 months].Univariate analysis showed that immunophenotyping,clinical stage,B symptoms,physical status score,international prognostic index score(IPI score),NLR,acute monocyte count(AMC),LDH,Alb,anemia and β2 microglobulin(β2 M)were prognostic factors affecting OS and PFS in patients with NHL.Multivariate analysis showed that clinical stage(HR=1.651,P=0.040)and immune phenotype(HR=2.022,P=0.040)were independent predictors of OS in patients with NHL,and clinical stage(HR=1.605,P=0.016)was an independent predictor of PFS in patients with NHL.Conclusions Although multivariate analysis has not shown that NLR is an independent predictors of OS or PFS for NHL,univariate analysis shows that NLR still has a clinical guidance in evaluating NHL patients’ prognosis.
作者
林海燕
陈飞
LIN Hai-yan;CHEN Fei(Department of Hematology,Zhongnan Hospital of Wuhan University,Wuhan 430071,China)
出处
《中华肿瘤防治杂志》
CAS
北大核心
2021年第5期360-364,共5页
Chinese Journal of Cancer Prevention and Treatment
