外周血中性粒细胞及血小板与淋巴细胞的比值与局部晚期鼻咽癌预后及疗效的相关性

唐红; 吴伟莉; 金风; 龙金华; 李媛媛; 罗秀玲; 龚修云; 陈潇潇; 张芒; 杨春李

doi:10.3971/j.issn.1000-8578.2019.18.0578

外周血中性粒细胞及血小板与淋巴细胞的比值与局部晚期鼻咽癌预后及疗效的相关性

Relationship of Peripheral Blood Neutrophil/Lymphocyte Ratio and Platelet/Lymphocyte Ratio with Curative Effect and Prognosis of Patients with Locally Advanced Nasopharyngeal Carcinoma

摘要

摘要:
目的探讨中性粒细胞与淋巴细胞比值（neutrophil-to-lymphocyte ratio, NLR）以及血小板与淋巴细胞比值（platelet-lymphocyte ratio, PLR）对局部晚期鼻咽癌患者临床预后及疗效的预测价值。
方法收集2015年7月—2016年12月贵州省肿瘤医院一项随机前瞻性临床试验的局部晚期鼻咽癌患者的临床资料。患者均行2周期TPF诱导化疗及顺铂同步放化疗。研究治疗前NLR、PLR与患者治疗疗效的关系。并探讨时辰组及常规组间疗效的差异。
结果 Ⅳa/b期患者NLR、PLR均值较Ⅲ期患者高（P=0.010）；低PLR组治疗后转移淋巴结即刻疗效较高PLR组好（P=0.029），放疗结束3月后原发灶疗效及总体疗效较高PLR组好（P=0.012, P=0.027）；高、低NLR及PLR组中常规组及时辰组的治疗后即刻疗效及放疗结束后3月疗效差异无统计学意义（P > 0.05）。
结论 NLR和PLR均与鼻咽癌临床分期有关，肿瘤分期越晚，NLR和PLR值越高。NLR对患者的近期疗效预测价值欠佳，PLR可能是局部晚期鼻咽癌患者近期疗效的预测指标，高PLR可能预示较差的近期疗效。

Abstract:
Objective To explore the predictive value of neutrophil-to-lymphocyte ratio(NLR) and platelet-to-lymphocyte ratio (PLR) in the prognosis and curative effect of locally advanced nasopharyngeal carcinoma(NPC) patients.
Methods We collected the clinical information of locally advanced NPC patients from a randomized prospective clinical trial in Guizhou cancer hospital from July 2015 to December 2016. The patients were treated with two cycles of TPF induction chemotherapy and cisplatin-based concurrent chemoradiotherapy. The relationship between NLR, PLR before treatment and the therapeutic effect of patients was analyzed. We compared the curative effect between chrono-chemotherapy group and routine group.
Results The mean values of NLR and PLR in stage Ⅳa/b patients were higher than those in stage Ⅲ patients (P=0.010); the immediate effect of metastatic lymph nodes in low PLR group was better than that in high PLR group (P=0.029), and the curative effect of primary lesion and overall curative effect three months after radiotherapy were better in low PLR group (P=0.012, P=0.027); there was no significant difference in immediate effect or overall curative effect three months after radiotherapy between conventional group and chronological group (P > 0.05).
Conclusion NLR and PLR are related to the clinical staging of nasopharyngeal carcinoma. The later tumor stage is, the higher NLR and PLR values are. The predictive value of NLR for the patients' short-term efficacy is not well. PLR may be a predictor for recent outcomes of patients with locally advanced nasopharyngeal carcinoma, and high PLR may predict poor short-term efficacy.

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