国际肿瘤学杂志

国际肿瘤学杂志 ›› 2016, Vol. 43 ›› Issue (7): 490-494.doi: 10.3760/cma.j.issn.1673422X.2016.07.003

• 论著 • 上一篇    下一篇

化疗前后NLR、血小板计数对评估晚期非小细胞肺癌患者预后的价值

张艳芳, 夏金, 李醒亚   

  1. 河南省安阳市肿瘤医院内五科
  • 出版日期:2016-07-08 发布日期:2016-06-03
  • 基金资助:

    河南省医学科技攻关项目（201203143）

Prognostic values of NLR and platelet count before and after chemotherapy in patients with advanced nonsmall cell lung cancer

ZHANG  Yan-Fang, XIA  Jin, LI  Xing-Ya   

  1. Fifth Department of Internal Medicine, Anyang Cancer Hospital of He′nan Province, Anyang 455000, China
  • Online:2016-07-08 Published:2016-06-03
  • Supported by:

    Medical Science Research Project of He′nan Province (201203143)

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被引次数

2

摘要： 目的探讨化疗前后中性粒细胞/淋巴细胞比值（NLR）、血小板计数对晚期非小细胞肺癌（NSCLC）患者预后的判断价值。方法选取河南省安阳市肿瘤医院2011年10月—2012年12月收治的70例晚期NSCLC患者为研究对象，收集化疗前及化疗2周期后NLR及血小板水平。NLR以中位数3.43为界，分低NLR及高NLR组；血小板≥300×109/L为血小板升高组，100×109/L＜血小板<300×109/L为正常组。化疗2周期后根据NLR变化，分为3组：①化疗前低NLR组；②化疗前高NLR化疗后降为低NLR组；③化疗前高NLR化疗后仍为高NLR组。根据化疗前后血小板计数的变化分为3组：①化疗前血小板正常组；②化疗前血小板升高化疗后降至正常组；③化疗前血小板升高化疗后仍为升高组。对比不同组患者的临床病理特征和远期生存。结果低NLR组、高NLR组患者中位生存时间分别为16.0、12.5个月，差异有统计学意义（χ2=3.654，P=0.041）。血小板正常组、升高组中位生存时间分别为14.3、10.0个月，差异有统计学意义（χ2=5.358，P=0.021）。化疗前后NLR变化3组患者的中位生存时间分别为14.5、12.1、9.0个月，差异有统计学意义（χ2=7.701，P=0.021）。血小板计数变化3组患者中位生存时间分别为14.3、13.1、10.4个月，差异有统计学意义（χ2=12.775，P=0.002）。COX多因素分析显示NLR（RR=1.467，95%CI为1.014~2.124，χ2=4.130，P=0.042）、血小板（RR=1.631，95%CI为1.108~2.402，χ2=6.137，P=0.013）和TNM分期（RR=1.380，95%CI为1.052~1.809，χ2=5.420，P=0.020）均是影响晚期NSCLC患者预后的独立预后因素。结论化疗前NLR和血小板计数与患者不良预后有关，NLR和血小板升高，患者生存期缩短。

关键词: 癌, 非小细胞肺, 淋巴细胞, 血小板, 预后, 粒细胞

Abstract: bjectiveTo investigate the prognostic values of neutrophil to lymphocyte ratio (NLR) and platelet count before and after chemotherapy in patients with advanced nonsmall cell lung cancer (NSCLC). MethodsFrom October 2011 to December 2012, 70 patients with advanced NSCLC in Anyang Cancer Hospital of Henan Province were collected. NLR and platelet were calculated from complete blood counts in laboratory test before and after 2 cycles of chemotherapy. The patients were divided into two groups according to the NLR and platelet count: low NLR group (≤3.43) and high NLR group (>3.43); normal group (100×109/L＜platelet count＜300×109/L) and high platelet group (≥300×109/L). According to the changes of NLR before and after chemotherapy, we divided the patients into 3 groups: ①low NLR group before chemotherapy; ②high NLR group before but declined to low NLR group after chemotherapy; ③high NLR group before and after chemotherapy. According to the changes of platelet count before and after chemotherapy, we divided the patients into 3 groups: ①normal platelet count group before chemotherapy; ②high platelet count group before but declined to normal group after chemotherapy; ③high platelet count group before and after chemotherapy. The clinicopathological characteristics and longterm survivals between the subgroups were compared. ResultsThe median survival time of the low and high NLR group were 16.0 and 12.5 months, respectively, with a significant difference (χ2=3.654, P=0.041). The median survival time of the normal and high platelet group were 14.3 and 10.0 months, respectively, with a significant difference (χ2=5.358, P=0.021). The median survival times of patients in the 3 groups according to the changes of NLR before and after chemotherapy were 14.5, 12.1 and 9.0 months respectively, with statistically significant (χ2=7.701, P=0.021). The median survival times of patients in the 3 groups according to the changes of platelet count before and after chemotherapy were 14.3, 13.1 and 10.4 months, with statistically significant (χ2=12.775, P=0.002). COX multivariate analysis showed that NLR (RR=1.467, 95%CI: 1.0142.124, χ2=4.130, P=0.042)， platelet (RR=1.631, 95%CI: 1.1082.402, χ2=6.137, P=0.013) and TNM stage（RR=1.380，95%CI为1.0521.809， χ2=5.420，P=0.020） were independent prognostic factors of patients with advanced NSCLC. ConclusionNLR and platelet before chemotherapy are independent risk factors for patients with advanced NSCLC. Patients with elevated NLR and platelet have shorter survival time.

Key words: Carcinoma, nonsmallcell lung, Lymphocytes, Blood platelets, Prognosis,  , Granulocytes