营养炎症指标在卵巢恶性肿瘤预后评估中的 应用
The Application of Nutritional Inflammatory Indicators in the Prognostic Assessment of Ovarian Malignant Tumors
DOI: 10.12677/acm.2026.1641579, PDF,   
作者: 黄 琴, 王 辉*:重庆医科大学第一临床学院,重庆
关键词: 卵巢癌肿瘤微环境预后评分Ovarian Cancer Tumor Microenvironment Prognostic Score
摘要: 卵巢癌缺乏早期有效筛查手段,患者确诊时多为晚期,预后较差。近年有些研究发现炎症反应与营养状态参与了卵巢癌发生、发展,并对患者预后预测有一定指导意义。本文系统综述了常用营养炎症指标(如中性粒细胞与淋巴细胞比值NLR、淋巴细胞与单核细胞比值LMR、血小板与淋巴细胞比值PLR、白蛋白)、复合营养炎症指标(如PNI、CONUT、SII等)与卵巢癌预后的关系,为临床工作中患者的预后评估提供参考。
Abstract: Ovarian cancer lacks effective early screening methods, with most patients being diagnosed at advanced stages and having poor prognoses. In recent years, some studies have found that inflammatory responses and nutritional status are involved in the occurrence and progression of ovarian cancer, and hold certain predictive value for patient prognosis. This article systematically reviews the relationship between common nutritional-inflammatory indicators (such as neutrophil-to-lymphocyte ratio [NLR], lymphocyte-to-monocyte ratio [LMR], platelet-to-lymphocyte ratio [PLR], and albumin), composite nutritional-inflammatory indicators (such as PNI, CONUT, SII, etc.) and the prognosis of ovarian cancer, providing reference for prognostic assessment of patients in clinical practice.
文章引用:黄琴, 王辉. 营养炎症指标在卵巢恶性肿瘤预后评估中的 应用[J]. 临床医学进展, 2026, 16(4): 3197-3205. https://doi.org/10.12677/acm.2026.1641579

参考文献

[1] Sung, H., Ferlay, J., Siegel, R.L., Laversanne, M., Soerjomataram, I., Jemal, A., et al. (2021) Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA: A Cancer Journal for Clinicians, 71, 209-249. [Google Scholar] [CrossRef] [PubMed]
[2] Fumagalli, D., De Vitis, L.A., Sonik, R., Jatoi, A. and Kumar, A. (2025) Many Ways, One Destination: A Comprehensive Review of Screening and Assessment Tools to Detect Malnutrition in Patients with Ovarian Cancer. International Journal of Gynecological Cancer, 35, Article ID: 100036. [Google Scholar] [CrossRef] [PubMed]
[3] Bacalbasa, N., Petrea, S., Gaspar, B., Pop, L., Varlas, V., Hasegan, A., et al. (2024) The Influence of Inflammatory and Nutritional Status on the Long-Term Outcomes in Advanced Stage Ovarian Cancer. Cancers, 16, Article 2504. [Google Scholar] [CrossRef] [PubMed]
[4] Hrvat, A., Benders, S., Kimmig, R., Brandau, S. and Mallmann-Gottschalk, N. (2024) Immunoglobulins and Serum Proteins Impair Anti-Tumor NK Cell Effector Functions in Malignant Ascites. Frontiers in Immunology, 15, Article 1360615. [Google Scholar] [CrossRef] [PubMed]
[5] Peng, C., Xu, Y., Wu, J., Wu, D., Zhou, L. and Xia, X. (2024) TME-Related Biomimetic Strategies against Cancer. International Journal of Nanomedicine, 19, 109-135. [Google Scholar] [CrossRef] [PubMed]
[6] Bilotta, M.T., Antignani, A. and Fitzgerald, D.J. (2022) Managing the TME to Improve the Efficacy of Cancer Therapy. Frontiers in Immunology, 13, Article 854992. [Google Scholar] [CrossRef] [PubMed]
[7] Schiefer, S., Wirsik, N.M., Kalkum, E., Seide, S.E., Nienhüser, H., Müller, B., et al. (2022) Systematic Review of Prognostic Role of Blood Cell Ratios in Patients with Gastric Cancer Undergoing Surgery. Diagnostics, 12, Article 593. [Google Scholar] [CrossRef] [PubMed]
[8] Arianmanesh, F., Bagheri, S., Karimi, M.A., Izadi, S. and Ahmadi, M.H. (2025) The Evaluation of Diagnostic, Prognostic, and Predictive Role of Hematologic Inflammatory Indices NLR, PLR, and LMR in Common Solid Tumors. Cancer Reports, 8, e70407. [Google Scholar] [CrossRef
[9] Han, Y., Zheng, S. and Chen, Y. (2024) Prognostic Value of Lymphocyte to Monocyte Ratio in Patients with Esophageal Cancer: A Systematic Review and Meta-Analysis. Frontiers in Oncology, 14, Article 1401076. [Google Scholar] [CrossRef] [PubMed]
[10] Gong, Z., Xin, R., Li, L., Lv, L. and Wu, X. (2022) Platelet-to-lymphocyte Ratio Associated with the Clinicopathological Features and Prognostic Value of Breast Cancer: A Meta-analysis. The International Journal of Biological Markers, 37, 339-348. [Google Scholar] [CrossRef] [PubMed]
[11] Wu, M., Ma, M., Tan, Z., Zheng, H. and Liu, X. (2020) Neutrophil: A New Player in Metastatic Cancers. Frontiers in Immunology, 11, Article 565165. [Google Scholar] [CrossRef] [PubMed]
[12] Tian, Y., Li, X., Zhang, H., Wang, Y., Li, H. and Qin, Q. (2024) Serum NLR Combined with CA125 and HE4 Improves the Diagnostic and Prognostic Efficiency in Patients with Ovarian Cancer. Frontiers in Oncology, 14, Article 1494051. [Google Scholar] [CrossRef] [PubMed]
[13] Huo, C., Wu, B., Ye, D., Xu, M., Ma, S., Cheng, A., et al. (2024) New Prognostic Index for Neoadjuvant Chemotherapy Outcome in Patients with Advanced High-Grade Serous Ovarian Cancer. BMC Cancer, 24, Article No. 1536. [Google Scholar] [CrossRef] [PubMed]
[14] Gallego, A., Mendiola, M., Hernando, B., Berjon, A., Cadiz, A., Chaves-Urbano, B., et al. (2022) Prognostic Markers of Inflammation in Endometrioid and Clear Cell Ovarian Cancer. International Journal of Gynecological Cancer, 32, 1009-1016. [Google Scholar] [CrossRef] [PubMed]
[15] Rab, S.O., Altalbawy, F.M.A., Bishoyi, A.K., Ballal, S., Kareem, M., Singh, A., et al. (2025) Targeting Platelet-Tumor Cell Interactions: A Novel Approach to Cancer Therapy. Medical Oncology, 42, Article No. 232. [Google Scholar] [CrossRef] [PubMed]
[16] Asher, V., Lee, J., Innamaa, A. and Bali, A. (2011) Preoperative Platelet Lymphocyte Ratio as an Independent Prognostic Marker in Ovarian Cancer. Clinical and Translational Oncology, 13, 499-503. [Google Scholar] [CrossRef] [PubMed]
[17] Dinca, A. (2024) Systemic Inflammatory Markers-Prognostic Value in Ovarian Cancer. Acta Endocrinologica (Bucharest), 20, 162-169. [Google Scholar] [CrossRef] [PubMed]
[18] Chon, S., Lee, S., Jeong, D., Lim, S., Lee, K. and Shin, J. (2021) Elevated Platelet Lymphocyte Ratio Is a Poor Prognostic Factor in Advanced Epithelial Ovarian Cancer. Journal of Gynecology Obstetrics and Human Reproduction, 50, Article ID: 101849. [Google Scholar] [CrossRef] [PubMed]
[19] Zhang, W., Liu, K., Hu, G. and Liang, W. (2015) Preoperative Platelet/Lymphocyte Ratio Is a Superior Prognostic Factor Compared to Other Systemic Inflammatory Response Markers in Ovarian Cancer Patients. Tumor Biology, 36, 8831-8837. [Google Scholar] [CrossRef] [PubMed]
[20] Winata, I.G., Pradnyana, I.W.A.S., Yusrika, M., Pradnyaandara, I.G.B.M.A. and Pradnyadevi, P.A.S. (2024) Neutrophil to Lymphocyte Ratio and Platelet to Lymphocyte Ratio as an Early Prognostic Marker in Patients with Ovarian Cancer: A Systematic Review and Meta-Analysis. Asian Pacific Journal of Cancer Prevention, 25, 1921-1927. [Google Scholar] [CrossRef] [PubMed]
[21] Bai, H., Feng, L. and Schmid, F. (2024) Macrophage-Based Cancer Immunotherapy: Challenges and Opportunities. Experimental Cell Research, 442, Article ID: 114198. [Google Scholar] [CrossRef] [PubMed]
[22] Hu, Q., Shen, G., Li, Y., Xie, Y., Ma, X., Jiang, L., et al. (2023) Lymphocyte-To-Monocyte Ratio after Primary Surgery Is an Independent Prognostic Factor for Patients with Epithelial Ovarian Cancer: A Propensity Score Matching Analysis. Frontiers in Oncology, 13, Article 1139929. [Google Scholar] [CrossRef] [PubMed]
[23] Zhu, J., Liu, C., Wang, L., Zhong, M., Tang, H. and Wang, H. (2017) Peripheral Blood Lymphocyte-To-Monocyte Ratio as a Prognostic Factor in Advanced Epithelial Ovarian Cancer: A Multicenter Retrospective Study. Journal of Cancer, 8, 737-743. [Google Scholar] [CrossRef] [PubMed]
[24] Larson, D.W., Abd El Aziz, M.A., Perry, W., D’Angelo, A., Behm, K.T., Mathis, K.L., et al. (2020) Additional Value of Preoperative Albumin for Surgical Risk Stratification among Colorectal Cancer Patients. Annals of Nutrition and Metabolism, 76, 422-430. [Google Scholar] [CrossRef] [PubMed]
[25] Fujii, T., Tokuda, S., Nakazawa, Y., Kurozumi, S., Obayashi, S., Yajima, R., et al. (2020) Implications of Low Serum Albumin as a Prognostic Factor of Long-Term Outcomes in Patients with Breast Cancer. In Vivo, 34, 2033-2036. [Google Scholar] [CrossRef] [PubMed]
[26] Tang, Q., Li, X. and Sun, C. (2024) Predictive Value of Serum Albumin Levels on Cancer Survival: A Prospective Cohort Study. Frontiers in Oncology, 14, Article 1323192. [Google Scholar] [CrossRef] [PubMed]
[27] Chauhan, S., Langstraat, C.L., Fought, A.J., McGree, M.E., Cliby, W.A. and Kumar, A. (2024) Relationship between Frailty and Nutrition: Refining Predictors of Mortality after Primary Cytoreductive Surgery for Ovarian Cancer. Gynecologic Oncology, 180, 126-131. [Google Scholar] [CrossRef] [PubMed]
[28] Peippo, M.H., Perkonoja, K., Isoviita, V., Hynninen, J., Lassila, R. and Carpén, O. (2025) Association of Clinical and Laboratory Variables with Risk of Venous Thromboembolism in High-Grade Serous Ovarian Cancer. International Journal of Gynecological Cancer, 35, Article ID: 100019. [Google Scholar] [CrossRef] [PubMed]
[29] Si, Y., Song, N. and Ji, Y. (2024) Construction of a Nomogram Model for Predicting the Outcome of Debulking Surgery for Ovarian Cancer on the Basis of Clinical Indicators. Frontiers in Oncology, 14, Article 1421247. [Google Scholar] [CrossRef] [PubMed]
[30] Onodera, T., Goseki, N. and Kosaki, G. (1984) [Prognostic Nutritional Index in Gastrointestinal Surgery of Malnourished Cancer Patients]. Nihon Geka Gakkai Zasshi, 85, 1001-1005.
[31] Fridman, W.H., Meylan, M., Pupier, G., Calvez, A., Hernandez, I. and Sautès-Fridman, C. (2023) Tertiary Lymphoid Structures and B Cells: An Intratumoral Immunity Cycle. Immunity, 56, 2254-2269. [Google Scholar] [CrossRef] [PubMed]
[32] Yan, X., Xu, W., Yao, H., Wu, Z., Ning, J., Zhao, S., et al. (2026) Activation of T Cell-Intrinsic P53 by Acetylation Elicits Antitumor Immunity to Boost Cancer Immunotherapy. Cancer Discovery, 16, 155-176. [Google Scholar] [CrossRef
[33] Xing, L., Chen, R., Qian, J., Ren, J. and Deng, X. (2022) A Comparison of Three Preoperative Nutritional Assessment Methods for Predicting Ovarian Cancer Patient Prognosis: Which Is Better? Supportive Care in Cancer, 30, 5221-5229. [Google Scholar] [CrossRef] [PubMed]
[34] Miao, Y., Li, S., Yan, Q., Li, B. and Feng, Y. (2016) Prognostic Significance of Preoperative Prognostic Nutritional Index in Epithelial Ovarian Cancer Patients Treated with Platinum-Based Chemotherapy. Oncology Research and Treatment, 39, 712-719. [Google Scholar] [CrossRef] [PubMed]
[35] Ignacio De Ulíbarri, J., González-Madroño, A., De Villar, N.G., et al. (2005) CONUT: A Tool for Controlling Nutritional Status. First Validation in a Hospital Population. Nutrición Hospitalaria, 20, 38-45.
[36] Dalmiglio, C., Brilli, L., Campanile, M., Ciuoli, C., Cartocci, A. and Castagna, M.G. (2022) CONUT Score: A New Tool for Predicting Prognosis in Patients with Advanced Thyroid Cancer Treated with TKI. Cancers, 14, Article 724. [Google Scholar] [CrossRef] [PubMed]
[37] Shiihara, M., Higuchi, R., Izumo, W., Yazawa, T., Uemura, S., Furukawa, T., et al. (2021) Impact of the Controlling Nutritional Status Score on Severe Postoperative Complications of Pancreaticoduodenectomy for Pancreatic Cancer. Langenbecks Archives of Surgery, 406, 1491-1498. [Google Scholar] [CrossRef] [PubMed]
[38] Li, Y., Zhang, C., Ji, R., Lu, H., Zhang, W., Li, L., et al. (2020) Prognostic Significance of the Controlling Nutritional Status (CONUT) Score in Epithelial Ovarian Cancer. International Journal of Gynecological Cancer, 30, 74-82. [Google Scholar] [CrossRef] [PubMed]
[39] Bekos, C., Grimm, C., Gensthaler, L., Bartl, T., Reinthaller, A., Schwameis, R., et al. (2022) The Pretreatment Controlling Nutritional Status Score in Ovarian Cancer: Influence on Prognosis, Surgical Outcome, and Postoperative Complication Rate. Geburtshilfe und Frauenheilkunde, 82, 59-67. [Google Scholar] [CrossRef] [PubMed]
[40] Peng, Q., Zhan, C., Shen, Y., Xu, Y., Ren, B., Feng, Z., et al. (2024) Blood Lipid Metabolic Biomarkers Are Emerging as Significant Prognostic Indicators for Survival in Cancer Patients. BMC Cancer, 24, Article No. 1549. [Google Scholar] [CrossRef] [PubMed]
[41] Yang, W., Bai, Y., Xiong, Y., Zhang, J., Chen, S., Zheng, X., et al. (2016) Potentiating the Antitumour Response of CD8+ T Cells by Modulating Cholesterol Metabolism. Nature, 531, 651-655. [Google Scholar] [CrossRef] [PubMed]
[42] Wang, A., He, Z., Cong, P., Qu, Y., Hu, T., Cai, Y., et al. (2021) Controlling Nutritional Status (CONUT) Score as a New Indicator of Prognosis in Patients with Hilar Cholangiocarcinoma Is Superior to NLR and PNI: A Single-Center Retrospective Study. Frontiers in Oncology, 10, Article 593452. [Google Scholar] [CrossRef] [PubMed]
[43] Hu, B., Yang, X., Xu, Y., Sun, Y., Sun, C., Guo, W., et al. (2014) Systemic Immune-Inflammation Index Predicts Prognosis of Patients after Curative Resection for Hepatocellular Carcinoma. Clinical Cancer Research, 20, 6212-6222. [Google Scholar] [CrossRef] [PubMed]
[44] Chen, J., Jin, L., Luo, R., Zhang, X., Chen, Y., Han, Z., et al. (2025) Predictive Value of Preoperative Systemic Immune-Inflammation Index and Prognostic Nutrition Index in Patients with Epithelial Ovarian Cancer. Journal of Ovarian Research, 18, Article No. 45. [Google Scholar] [CrossRef] [PubMed]
[45] Bektaş, O. and Bektaş, K. (2025) Prognostic Value of Systemic Inflammatory Markers in Predicting Neoadjuvant Platinum Response and Platinum Resistance in Advanced Epithelial Ovarian Cancer: A Peritoneal Cancer Index-Based Analysis. Gynecologic Oncology, 199, 147-151. [Google Scholar] [CrossRef] [PubMed]