NLR对晚期胰腺癌患者预后的预测价值

Prognostic Value of NLR in Patients with Advanced Pancreatic Cancer

摘要: 目的：胰腺癌(Pancreatic Cancer)是世界上最常见及最致命的恶性肿瘤之一，炎症参与了肿瘤的浸润、进展、转移，本研究的目的是探讨中性粒细胞、淋巴细胞数比值(neutrophil to lymphocyte ratio, NLR)对晚期胰腺癌患者预后的预测价值。方法：回顾性分析2000年1月至2019年12月在青岛大学附属医院住院并于确诊后5年随访的晚期胰腺癌患者。收集临床资料和实验室检查指标，计算NLR值，并使用中位数作为截断值。采用Cox比例风险模型进行单因素及多因素分析，评价NLR对于晚期胰腺癌患者预后的预测价值。并使用Kaplan-Meier (K-M)绘制生存曲线，曲线之间的差异通过Log-Rank检验进行分析。结果：共有220名患者(中位年龄61.00岁；139 [63.2%]男性)符合纳入标准。根据中位数，将患者分为高NLR组和低NLR组，最佳截断值为2.54。通过Cox比例风险回归模型对患者总生存期进行单因素及多因素分析，多因素分析结果示，高NLR为晚期胰腺癌患者总生存期短的独立危险因素(HR = 1.537，95%置信区间为1.177~2.008；P = 0.002)。结论：高水平的NLR是晚期胰腺癌患者无病生存期短的独立危险因素。

Abstract: Objectives: Pancreatic cancer is one of the most common and fatal malignant tumors in the world. Inflammation is involved in tumor progression and metastasis. The purpose of this study is to ex-plore the prognostic value of neutrophil and lymphocyte ratio (NLR) in patients with advanced pancreatic cancer. Methods: The patients with advanced pancreatic cancer who were admitted to the Affiliated Hospital of Qingdao University from January 2000 to December 2019 and were fol-lowed up for 5 years were retrospectively analyzed. Collect clinical data and laboratory indexes, calculate NLR value, and use the median as the cut-off value. Cox proportional hazards model was used to analyze the prognostic value of NLR in patients with advanced pancreatic cancer by uni-variate and multivariate analysis. Kaplan Meier (K-M) was used to draw the survival curve, and the differences between the curves were analyzed by log rank test. Results: A total of 220 patients (me-dian age 61.00 years; 139 [63.2%] men) met the inclusion criteria. According to the median, the patients were divided into high NLR group and low NLR group, and the optimal cutoff value was 2.54. Univariate and multivariate analyses of overall survival were performed by Cox proportional hazards regression model. Multivariate analysis showed that high NLR was an independent risk factor for short overall survival in patients with advanced pancreatic cancer (HR = 1.537, 95% con-fidence interval 1.177~2.008; P = 0.002). Conclusion: High level of NLR is an independent risk factor for the short-term overall survival of patients with advanced pancreatic cancer.