肿瘤诊治新视角：血液炎症指标的临床应用与研究进展
New Perspectives in the Diagnosis and Treatment of Tumor: Clinical Applications and Research Progress of Blood Inflammatory Indicators
摘要: 在肿瘤的诊断与治疗领域，血液炎症指标作为评价患者免疫与炎症状态的重要工具，已逐渐显现其临床价值。中性粒细胞与淋巴细胞比值(Neutrophil to Lymphocyte Ratio, NLR)、血小板与淋巴细胞比值(Platelet to Lymphocyte Ratio, PLR)以及全身免疫炎症指数(Systemic Immune-Inflammation Index, SII)等指标可用于评估患者的免疫和炎症状况。近年来，学者们发现血液炎症指标与恶性肿瘤的发病、进展和预后密切相关。本文从诊断、预后评估、治疗疗效监测和免疫炎症反应评估等方面，对血液炎症指标在恶性肿瘤中的应用及研究进展进行综述，旨在为肿瘤临床诊治提供新的视角和实践依据。
Abstract: In the field of tumor diagnosis and treatment, blood inflammatory indicators have become an im-portant tool for evaluating the immune and inflammatory status of patients, and their clinical value is gradually being recognized. Indicators such as the Neutrophil to Lymphocyte Ratio (NLR), Platelet to Lymphocyte Ratio (PLR), and the Systemic Immune-Inflammation Index (SII) can be used to as-sess the immune and inflammatory status of patients. In recent years, researchers have found that blood inflammatory indicators are closely related to the incidence, progression, and prognosis of malignant tumors. This article reviews the application and research progress of blood inflammatory indicators in malignant tumors from the aspects of diagnosis, prognostic evaluation, monitoring therapeutic efficacy, and assessing immune-inflammatory responses, with the aim of providing new perspectives and practical evidence for the clinical diagnosis and treatment of cancer.
文章引用：肖雨, 齐洪志. 肿瘤诊治新视角：血液炎症指标的临床应用与研究进展[J]. 临床医学进展, 2024, 14(1): 945-953. https://doi.org/10.12677/ACM.2024.141135

参考文献

[1] Torre, L.A., Siegel, R.L., Ward, E.M. and Jemal, A. (2016) Global Cancer Incidence and Mortality Rates and Trends—An Update. Cancer Epidemiology, Biomarkers & Prevention, 25, 16-27. [Google Scholar] [CrossRef] 
[2] Singh, N., Baby, D., Rajguru, J.P., Patil, P.B., Thakkannavar, S.S. and Pujari, V.B. (2019) Inflammation and Cancer. Annals of African Medicine, 18, 121-126. [Google Scholar] [CrossRef] [PubMed]
[3] Arneth, B. (2019) Tumor Microenvironment. Medicina, 56, Article 15. [Google Scholar] [CrossRef] [PubMed]
[4] Smith, J.A. (1994) Neutrophils, Host Defense, and Inflamma-tion: A Double-Edged Sword. Journal of Leukocyte Biology, 56, 672-686. [Google Scholar] [CrossRef] [PubMed]
[5] Gao, F., Feng, Y., Hu, X., Zhang, X., Li, T., Wang, Y., Ge, S., Wang, C., Chi, J., Tan, X. and Wang, N. (2023) Neutrophils Regulate Tumor Angiogenesis in Oral Squamous Cell Carcinoma and the Role of Chemerin. International Immunopharmacology, 121, Article ID: 110540. [Google Scholar] [CrossRef] [PubMed]
[6] Mizuno, R., Kawada, K., Itatani, Y., Ogawa, R., Kiyasu, Y. and Sakai, Y. (2019) The Role of Tumor-Associated Neutrophils in Colorectal Cancer. International Journal of Molecular Sciences, 20, Article 529. [Google Scholar] [CrossRef] [PubMed]
[7] Hong, Y.M., Yoon, K.T., Hwang, T.H. and Cho, M. (2020) Pretreat-ment Peripheral Neutrophils, Lymphocytes and Monocytes Predict Long-Term Survival in Hepatocellular Carcinoma. BMC Cancer, 20, Article No. 937. [Google Scholar] [CrossRef] [PubMed]
[8] Yin, W., Lv, J., Yao, Y., Zhao, Y., He, Z., Wang, Q., Cui, L. and Dai, H. (2021) Elevations of Monocyte and Neutrophils, and Higher Levels of Granulocyte Colony-Stimulating Factor in Peripheral Blood in Lung Cancer Patients. Thoracic Cancer, 12, 2680-2690. [Google Scholar] [CrossRef] [PubMed]
[9] Gungabeesoon, J., Gort-Freitas, N.A., Kiss, M., Bolli, E., Messe-maker, M., Siwicki, M., Hicham, M., Bill, R., Koch, P., Cianciaruso, C., Duval, F., Pfirschke, C., Mazzola, M., Peters, S., Homicsko, K., Garris, C., Weissleder, R., Klein, A.M. and Pittet, M.J. (2023) A Neutrophil Response Linked to Tu-mor Control in Immunotherapy. Cell, 186, 1448-1464.E20. [Google Scholar] [CrossRef] [PubMed]
[10] Vols, S., Sionov, R.V. and Granot, Z. (2017) Always Look on the Bright Side: Anti-Tumor Functions of Neutrophils. Current Pharmaceutical Design, 23, 4862-4892. [Google Scholar] [CrossRef] [PubMed]
[11] Abd Hamid, M., Peng, Y. and Dong, T. (2020) Human Cancer Germline Antigen-Specific Cytotoxic T Cell—What Can We Learn from Patient. Cellular & Molecular Immunology, 17, 684-692. [Google Scholar] [CrossRef] [PubMed]
[12] Voskoboinik, I., Whisstock, J.C. and Trapani, J.A. (2015) Per-forin and Granzymes: Function, Dysfunction and Human Pathology. Nature Reviews Immunology, 15, 388-400. [Google Scholar] [CrossRef] [PubMed]
[13] Barth Jr., R.J., Mulé, J.J., Spiess, P.J. and Rosenberg, S.A. (1991) Interferon γ and Tumor Necrosis Factor Have a Role in Tumor Regressions Mediated by Murine CD8+ Tumor-Infiltrating Lym-phocytes. Journal of Experimental Medicine, 173, 647-658. [Google Scholar] [CrossRef] [PubMed]
[14] Bennett, S.R., Carbone, F.R., Karamalis, F., Miller, J.F. and Heath, W.R. (1997) Induction of a CD8+ Cytotoxic T Lymphocyte Response by Cross-Priming Requires Cognate CD4+ T Cell Help. Journal of Experimental Medicine, 186, 65-70. [Google Scholar] [CrossRef] [PubMed]
[15] Ossendorp, F., Mengedé, E., Camps, M., Filius, R. and Melief, C.J. (1998) Specific T Helper Cell Requirement for Optimal Induction of Cytotoxic T Lymphocytes against Major Histocom-patibility Complex Class II Negative Tumors. Journal of Experimental Medicine, 187, 693-702. [Google Scholar] [CrossRef] [PubMed]
[16] Takagi, S., Sato, S., Oh-hara, T., Takami, M., Koike, S., Mishima, Y., Hatake, K. and Fujita, N. (2013) Platelets Promote Tumor Growth and Metastasis via Direct Interaction between Ag-grus/Podoplanin and CLEC-2. PLOS ONE, 8, e73609. [Google Scholar] [CrossRef] [PubMed]
[17] Lucotti, S. and Muschel, R.J. (2020) Platelets and Metastasis: New Implications of an Old Interplay. Frontiers in Oncology, 10, Article 1350. [Google Scholar] [CrossRef] [PubMed]
[18] Nieswandt, B., Hafner, M., Echtenacher, B. and Män-nel, D.N. (1999) Lysis of Tumor Cells by Natural Killer Cells in Mice Is Impeded by Platelets. Cancer Research, 59, 1295-1300.
[19] Battinelli, E.M., Markens, B.A. and Italiano Jr., J.E. (2011) Release of Angiogenesis Regulatory Pro-teins from Platelet α Granules: Modulation of Physiologic and Pathologic Angiogenesis. Blood, 118, 1359-1369. [Google Scholar] [CrossRef] [PubMed]
[20] Kopp, H.G., Placke, T. and Salih, H.R. (2009) Platelet-Derived Transforming Growth Factor-β Down-Regulates NKG2D Thereby Inhibiting Natural Killer Cell Antitumor Reactivity. Cancer Research, 69, 7775-7783. [Google Scholar] [CrossRef] 
[21] Schlesinger, M. (2018) Role of Platelets and Platelet Re-ceptors in Cancer Metastasis. Journal of Hematology & Oncology, 11, Article No. 125. [Google Scholar] [CrossRef] [PubMed]
[22] Xu, X.R., Carrim, N., Neves, M.A., McKeown, T., Stratton, T.W., Coelho, R.M., Lei, X., Chen, P., Xu, J., Dai, X., Li, B.X. and Ni, H. (2016) Platelets and Platelet Adhesion Mole-cules: Novel Mechanisms of Thrombosis and Anti-Thrombotic Therapies. Thrombosis Journal, 14, Article No. 29. [Google Scholar] [CrossRef] [PubMed]
[23] Hamidi, H. and Ivaska, J. (2018) Every Step of the Way: Integrins in Cancer Progression and Metastasis. Nature Reviews Cancer, 18, 533-548. [Google Scholar] [CrossRef] [PubMed]
[24] Berndt, M.C., Gregory, C., Kabral, A., Zola, H., Fournier, D. and Castaldi, P.A. (1985) Purification and Preliminary Characterization of the Glycoprotein Ib Complex in the Human Platelet Membrane. European Journal of Biochemistry, 151, 637-649. [Google Scholar] [CrossRef] [PubMed]
[25] Läubli, H. and Borsig, L. (2010) Selectins Promote Tu-mor Metastasis. Seminars in Cancer Biology, 20, 169-177. [Google Scholar] [CrossRef] [PubMed]
[26] Miao, Y., Xu, Z., Feng, W., Zheng, M., Xu, Z., Gao, H., Li, W., Zhang, Y., Zong, Y., Lu, A. and Zhao, J. (2022) Platelet Infiltration Predicts Survival in Postsurgical Colorectal Cancer Patients. International Journal of Cancer, 150, 509-520. [Google Scholar] [CrossRef] [PubMed]
[27] Caudell, J.J., Gillison, M.L., Maghami, E., Spencer, S., Pfister, D.G., Adkins, D., Birkeland, A.C., Brizel, D.M., Busse, P.M., Cmelak, A.J., Colevas, A.D., Eisele, D.W., Galloway, T., Geiger, J.L., Haddad, R.I., Hicks, W.L., Hitchcock, Y.J., Jimeno, A., Leizman, D., Mell, L.K., Mittal, B.B., Pinto, H.A., Rocco, J.W., Rodriguez, C.P., Savvides, P.S., Schwartz, D., Shah, J.P., Sher, D., St John, M., Weber, R.S., Weinstein, G., Worden, F., Yang Bruce, J., Yom, S.S., Zhen, W., Burns, J.L. and Darlow, S.D. (2022) NCCN Guidelines® Insights: Head and Neck Cancers, Version 1.2022. Journal of the National Comprehensive Cancer Network, 20, 224-234. [Google Scholar] [CrossRef] [PubMed]
[28] Lin, Z., Zhang, X., Luo, Y., Chen, Y. and Yuan, Y. (2021) The Value of Hemoglobin-to-Red Blood Cell Distribution Width Ra-tio (Hb/RDW), Neutrophil-to-Lymphocyte Ratio (NLR), and Platelet-to-Lymphocyte Ratio (PLR) for the Diagnosis of Nasopharyngeal Cancer. Medicine, 100, e26537. [Google Scholar] [CrossRef] 
[29] Jiang, W., Chen, Y., Huang, J., Xi, D., Chen, J., Shao, Y., Xu, G., Ying, W., Wei, J., Chen, J., Ning, Z., Gu, W. and Pei, H. (2017) Systemic Immune-Inflammation Index Predicts the Clinical Outcome in Patients with Nasopharyngeal Carcinoma: A Propensity Score-Matched Analysis. Oncotarget, 8, 66075-66086. [Google Scholar] [CrossRef] [PubMed]
[30] Gaudioso, P., Borsetto, D., Polesel, J., Tirelli, G., Emanuelli, E., Menegaldo, A., Molteni, G., Nicolai, P., Tomasoni, M., Montenegro, C., Piazza, C., Bossi, P., Ciorba, A., Canzi, P., Giacomarra, V., Giudici, F., Fussey, J. and, Boscolo-Rizzo, P. (2023) Blood Markers Predicting Clinically Occult Lymph Node Metastasis in Head and Neck Squamous Cell Carcinoma. ORL, 16, 1-9. [Google Scholar] [CrossRef] [PubMed]
[31] Zhao, L., Zhou, T., Zhang, W., Wu, F., Jiang, K., Lin, B., Zhan, S., Hu, T., Tang, T., Zhang, Y. and Luo, D. (2022) Blood Immune Indexes Can Predict Lateral Lymph Node Metastasis of Thyroid Papillary Carcinoma. Frontiers in Endocrinology, 13, Article 995630. [Google Scholar] [CrossRef] [PubMed]
[32] Siegel, R.L., Miller, K.D. and Jemal, A. (2020) Cancer Statistics, 2020. CA: A Cancer Journal for Clinicians, 70, 7-30. [Google Scholar] [CrossRef] [PubMed]
[33] Kang, J., Chang, Y., Ahn, J., Oh, S., Koo, D.H., Lee, Y.G., Shin, H. and Ryu, S. (2019) Neutrophil-to-Lymphocyte Ratio and Risk of Lung Cancer Mortality in a Low-Risk Population: A Cohort Study. International Journal of Cancer, 145, 3267-3275. [Google Scholar] [CrossRef] [PubMed]
[34] Tian, T., Lu, J., Zhao, W., Wang, Z., Xu, H., Ding, Y., Guo, W., Qin, P., Zhu, W., Song, C., Ma, H., Zhang, Q. and Shen, H. (2022) Associations of Systemic Inflammation Markers with Identification of Pulmonary Nodule and Incident Lung Cancer in Chinese Population. Cancer Medicine, 11, 2482-2491. [Google Scholar] [CrossRef] [PubMed]
[35] Delikgoz Soykut, E., Kemal, Y., Karacin, C., Karaoglanoglu, O., Kurt, M. and Aytac Arslan, S. (2022) Prognostic Impact of Immune In-flammation Biomarkers in Predicting Survival and Radiosensitivity in Patients with Non-Small-Cell Lung Cancer Treated with Chemoradiotherapy. Journal of Medical Imaging and Radiation Oncology, 66, 146-157. [Google Scholar] [CrossRef] [PubMed]
[36] Zhou, Y., Dai, M. and Zhang, Z. (2022) Prognostic Significance of the Systemic Immune-Inflammation Index (SII) in Patients with Small Cell Lung Cancer: A Meta-Analysis. Frontiers in Oncology, 12, Article 814727. [Google Scholar] [CrossRef] [PubMed]
[37] Sung, H., Ferlay, J., Siegel, R.L., et al. (2021) Global Cancer Sta-tistics 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]
[38] Thrift, A.P., Wenker, T.N. and El-Serag, H.B. (2023) Global Burden of Gastric Cancer: Epidemiological Trends, Risk Factors, Screening and Prevention. Nature Reviews Clinical Oncology, 20, 338-349. [Google Scholar] [CrossRef] [PubMed]
[39] Jiang, Y., Xu, D., Song, H., Qiu, B., Tian, D., Li, Z., Ji, Y. and Wang, J. (2021) Inflammation and Nutrition-Based Biomarkers in the Prognosis of Oesophageal Cancer: A Systematic Review and Meta-Analysis. BMJ Open, 11, e048324. [Google Scholar] [CrossRef] [PubMed]
[40] Wang, K., Diao, F., Ye, Z., Zhang, X., Zhai, E., Ren, H., Li, T., Wu, H., He, Y., Cai, S. and Chen, J. (2017) Prognostic Value of Systemic Immune-Inflammation Index in Patients with Gastric Cancer. Chinese Journal of Cancer, 36, Article No. 75. [Google Scholar] [CrossRef] [PubMed]
[41] Liang, Y., Wang, W., Fang, C., Raj, S.S., Hu, W.M., Li, Q.W. and Zhou, Z.W. (2016) Clinical Significance and Diagnostic Value of Serum CEA, CA19-9 and CA72-4 in Patients with Gastric Cancer. Oncotarget, 7, 49565-49573. [Google Scholar] [CrossRef] [PubMed]
[42] Fang, T., Wang, Y., Yin, X., Zhai, Z., Zhang, Y., Yang, Y., You, Q., Li, Z., Ma, Y., Li, C., Song, H., Shi, H., Zhang, Y., Yu, X., Gao, H., Sun, Y., Xie, R. and Xue, Y. (2020) Diagnos-tic Sensitivity of NLR and PLR in Early Diagnosis of Gastric Cancer. Journal of Immunology Research, 2020, Article ID: 9146042. [Google Scholar] [CrossRef] [PubMed]
[43] Yang, J., Guo, X., Wu, T., Niu, K. and Ma, X. (2019) Prognostic Significance of Inflammation-Based Indexes in Patients with Stage III/IV Colorectal Cancer after Adjuvant Chemoradiotherapy. Medicine, 98, e14420. [Google Scholar] [CrossRef] 
[44] Li, M., Li, Z., Wang, Z., Yue, C., Hu, W. and Lu, H. (2022) Prognostic Value of Systemic Immune-Inflammation Index in Patients with Pancreatic Cancer: A Meta-Analysis. Clinical and Experimental Medicine, 22, 637-646. [Google Scholar] [CrossRef] [PubMed]
[45] Arbyn, M., Weiderpass, E., Bruni, L., de Sanjosé, S., Saraiya, M., Ferlay, J. and Bray, F. (2020) Estimates of Incidence and Mortality of Cervical Cancer in 2018: A Worldwide Anal-ysis. The Lancet Global Health, 8, e191-e203. [Google Scholar] [CrossRef] 
[46] Tas, M., Yavuz, A., Ak, M. and Ozcelik, B. (2019) Neu-trophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio in Discriminating Precancerous Pathologies from Cervical Cancer. Journal of Oncology, 2019, Article ID: 2476082. [Google Scholar] [CrossRef] [PubMed]
[47] Nakamura, K., Nishida, T., Haruma, T., Haraga, J., Omichi, C., Ogawa, C., Kusumoto, T., Seki, N., Masuyama, H. and Hiramatsu, Y. (2015) Pretreatment Platelet-Lymphocyte Ratio Is an In-dependent Predictor of Cervical Cancer Recurrence Following Concurrent Chemoradiation Therapy. Molecular and Clin-ical Oncology, 3, 1001-1006. [Google Scholar] [CrossRef] [PubMed]
[48] Trinh, H., Dzul, S.P., Hyder, J., Jang, H., Kim, S., Flowers, J., Vaishampayan, N., Chen, J., Winer, I. and Miller, S. (2020) Prognostic Value of Changes in Neutrophil-to-Lymphocyte Ratio (NLR), Platelet-to-Lymphocyte Ratio (PLR) and Lymphocyte-to-Monocyte Ratio (LMR) for Patients with Cervical Cancer Undergoing Definitive Chemoradiotherapy (dCRT). Clinica Chimica Acta, 510, 711-716. [Google Scholar] [CrossRef] [PubMed]
[49] Lei, H., Xu, S., Mao, X., Chen, X., Chen, Y., Sun, X. and Sun, P. (2021) Systemic Immune-Inflammatory Index as a Predictor of Lymph Node Metastasis in Endometrial Cancer. Journal of Inflammation Research, 14, 7131-7142. [Google Scholar] [CrossRef] 
[50] Mirili, C., Paydas, S., Kapukaya, T.K. and Yılmaz, A. (2019) Systemic Immune-Inflammation Index Predicting Survival Outcome in Patients with Classical Hodgkin Lymphoma. Biomarkers in Medicine, 13, 1565-1575. [Google Scholar] [CrossRef] [PubMed]
[51] Wang, Z., Zhang, J., Luo, S. and Zhao, X. (2021) Prognostic Signif-icance of Systemic Immune-Inflammation Index in Patients with Diffuse Large B-Cell Lymphoma. Frontiers in Oncolo-gy, 11, Article 655259. [Google Scholar] [CrossRef] [PubMed]
[52] 李妍, 张合成, 王国锋, 范朋凯. 外周血中性粒细胞与淋巴细胞比值、淋巴细胞与单核细胞比值对患儿急性髓系白血病疗效及预后的评估价值[J]. 陕西医学杂志, 2022, 51(12): 1516-1519.

为你推荐