外周血炎性指标对晚期肝细胞癌患者免疫联合抗血管治疗疗效的预测价值

目的 探讨外周血炎性指标对于晚期肝细胞癌患者免疫联合抗血管生成治疗疗效的预测价值.方法 回顾性分析2018年3月13日至2019年1月3日参加卡瑞利珠单抗联合阿帕替尼治疗晚期肝细胞癌的国内多中心Ⅱ期临床试验(RESCUE研究)的189例患者临床资料,其中男169例,女20例;<60岁者145例,≥60岁者44例.计算治疗前外周血炎性指标,包括中性粒细胞与淋巴细胞比值(NLR)、血小板与淋巴细胞比值(PLR)、预后营养指数(PNI)和系统免疫炎症指数(SII),使用X-tile软件分别计算其最佳截断值,分析不同NLR、PLR、PNI和SII水平与肝细胞癌患者临床疗效及预后的相关性.采用Cox比例风险回归模型进行肝细胞癌患者预后的单因素和多因素分析.结果 NLR、PLR、PNI和SII的最佳截断值分别为2.25、147.3、48.0和819.0.分别以其最佳截断值为界,将189例患者进行分组,其中高NLR组(NLR≥2.25)110例,低NLR组(NLR<2.25)79例;高PLR组(PLR≥147.3)71例,低PLR组(PLR<147.3)118例;高PNI组(PNI≥48.0)113例,低PNI组(PNI<48.0)76例;高SII组(SII≥819.0)19例,低SII组(SII<819.0)170例.低NLR组患者的客观缓解率(ORR)高于高NLR组,差异有统计学意义(分别为35.4%和20.9%,P=0.026);低PLR组患者的疾病控制率(DCR)高于高PLR组,差异有统计学意义(分别为83.9%和66.2%,P=0.005);高PNI组患者的DCR高于低PNI组,差异有统计学意义(分别为84.1%和67.1%,P=0.006).低PLR组患者的中位无进展生存时间(PFS)明显长于高PLR组(分别为5.6和3.7个月,P=0.043),高PNI组患者的中位PFS明显长于低PNI组(分别为5.6和3.7个月,P=0.020);低NLR组患者的中位总生存时间(OS)明显长于高NLR组(分别为27.1和16.6个月,P=0.002),低PLR组患者的中位OS明显长于高PLR组(分别为24.3和17.4个月,P=0.011),高PNI组患者的中位OS明显长于低PNI组(分别为24.3和15.6个月,P=0.013),低SII组患者的中位OS明显长于高SII组(分别为22.6和13.5个月,P=0.002).单因素分析结果显示,患者的中位PFS与年龄、性别、PLR和PNI水平相关(均P<0.05);中位OS与Child-Pugh评分、基线乳酸脱氢酶水平、NLR、PLR、PNI及SII水平相关(均P<0.05).多因素分析结果显示,PLR(HR=1.423,95%CI:1.003~2.020,P=0.048)和PNI(HR=0.649,95%CI:0.459~0.916,P=0.014)均是影响患者PFS的独立因素;NLR(HR=1.645,95%CI:1.111~2.436,P=0.013)、PLR(HR=1.501,95%CI:1.037~2.173,P=0.031)和SII(HR=1.760,95%CI:1.007~3.075,P=0.047)均是影响患者OS的独立因素.结论 治疗前外周血NLR、PLR、PNI、SII水平对免疫联合抗血管生成治疗的晚期肝细胞癌患者的疗效和预后均具有一定的预测价值,低NLR、低PLR、低SII和高PNI水平可能提示疗效和预后较好.     

治疗前PLR和NLR对鼻咽癌患者预后的影响北大核心CSCD

目的探讨鼻咽癌患者治疗前外周血中血小板与淋巴细胞比(platelet-lymphocyte ratio,PLR)、中性粒细胞与淋巴细胞比(neutrophil-lymphocyte ratio,NLR)与总生存期(overall survival,OS)、无进展生存期(progression-free survival,PFS)的相关性。方法回顾性分析西安交通大学第一附属医院和陕西省人民医院2009年1月至2013年9月期间初治的91例鼻咽癌患者临床资料,根据ROC曲线选取PLR和NLR的截断值,将患者根据截断值分组,采用Kaplan-Meier法和Log rank检验比较不同组患者的总生存率和无进展生存率,应用Cox比例风险模型进行单因素和多因素分析。结果当PLR=143.3、NLR=2.6时,对患者的预后预测价值最高。Cox多因素分析发现PLR≥143.3(RR=2.491,95%CI=1.139~5.451,P=0.022)、NLR≥2.6(RR=2.186,95%CI=1.021~4.682,P=0.044)时,患者的OS较短,而PLR≥143.3(RR=2.461,95%CI=1.242~4.874,P=0.01)时,患者的PFS较差。结论治疗前PLR和NLR可能是影响鼻咽癌患者预后的独立危险因素。     

NLR、dNLR、PLR对195例广泛期小细胞肺癌预后评估价值分析

摘 要：［目的］ 探讨广泛期小细胞肺癌（small cell lung cancer）患者中性粒细胞/淋巴细胞比值（neutrophil-to-lymphocyte ratio，NLR）、血小板/淋巴细胞比值(platelet-to-lymphocyte ratio，PLR)、衍生中性粒细胞/淋巴细胞比值(derive neutrophil-to-lymphocyte ratio，dNLR)对预后的评估价值。［方法］ 选取195例广泛期SCLC患者，收集患者血常规数据，分析临床特征、NLR、dNLR、PLR对预后的影响。根据ROC曲线得到NLR、dNLR、PLR的最佳临界值，分析NLR、dNLR、PLR对广泛期SCLC患者PFS和OS的影响。［结果］ ROC曲线得到NLR、dNLR、PLR最佳临界值分别为2.4、2.2和170。单因素分析显示EP/C方案化疗＞4个周期、放疗、NLR≤2.4、dNLR≤2.2、PLR≤170与较长中位无进展生存期（progression-free survival，PFS）相关（P＜0.05），年龄≤60岁、女性、EP/C方案化疗＞4个周期、放疗、NLR≤2.4、dNLR≤2.2、PLR≤170与较长总生存期（overall survival，OS）相关。Cox回归分析显示放疗（HR=0.29，95%CI：0.20～0.42，P＜0.01）、EP/C方案化疗＞4个周期（HR=0.56，95%CI：0.39～0.79，P＜0.01）有利于PFS延长，NLR＞2.4（HR=1.64，95%CI：1.08～2.50，P=0.02）为PFS的危险因素；放疗（HR=0.24，95%CI：0.17～0.36，P＜0.01）、EP/C方案化疗＞4个周期（HR=0.64，95%CI：0.45～0.91，P=0.01）有利于OS延长，年龄＞60岁（HR=1.66，95%CI：1.16～2.36，P＜0.01）、NLR＞2.4（HR=2.60，95%CI：1.65～4.09，P＜0.01）、dNLR＞2.2（HR=1.651，95%CI：1.11～2.47，P=0.01）为OS的危险因素。［结论］ NLR、dNLR、PLR与广泛期SCLC患者预后相关，高NLR患者PFS较短，高NLR、高dNLR患者OS较短。     

血液学指标对鼻咽癌患者预后意义的系统评价

目的:评估血液学指标在鼻咽癌患者预后中的意义，指标包括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）、血浆纤维蛋白原水平、C-反应蛋白/白蛋白比值（CRP/ALB）、高密度脂蛋白胆固醇（HDL-C）。方法:计算机检索Medline、Embase、Cochrane Library、中国知网（CNKI）数据库、万方数据库、中国生物医学数据库（CBM），收集有关血液学相关指标与鼻咽癌患者预后相关的研究，主要观察指标为总生存期（OS），次要观察指标为无进展生存期（PFS）、无病生存期（DFS）、无远处转移生存期（DMFS）。结果:共纳入23项研究，NLR升高的患者OS、PFS均显著降低（HR=1.46，95％CI=1.30~1.63，P<0.000 01；HR=1.67，95％CI=1.36~2.07，P<0.000 01），PLR升高OS降低（HR=1.62，95％CI=1.32~1.98，P<0.000 01）。LMR升高则有益于患者预后（HR=0.50，95％CI=0.43~0.58，P<0.000 01）。CRP/ALB和血浆纤维蛋白原水平升高的患者预后差（P<0.000 01）。HDL-C水平与患者的OS无关（HR=1.22，95％CI=0.52~2.86，P=0.65）。结论:淋巴细胞、中性粒细胞、血小板、单核细胞、蛋白质（ALB，CRP）和纤维蛋白原可能是鼻咽癌患者预后的预测因素。     

血小板与淋巴细胞比值同小细胞肺癌临床预后的相关性分析

目的 本文主要探讨小细胞肺癌患者血小板与淋巴细胞比值同患者预后的关系。 方法 本文回顾性分析了首都医科大学附属北京康复医院2008年6月至2018年6月期间住院的小细胞肺癌患者共165例,收集患者血小板、淋巴细胞计数等临床资料,随访统计患者的生存期。通过SPSS 22.0统计软件中的ROC曲线,确定PLR的最佳界值,采用Kaplan-Meier法分析高PLR及低PLR组的生存,采用COX回归分析法行多因素分析。结果 利用ROC曲线求得最佳PLR界值为189,低PLR组（<189）为120例,高PLR组（≥189）为45例。低PLR组患者的无进展生存期高于高PLR组（8.6个月vs 6个月,P=0.016）,低PLR组患者总生存高于高PLR组（13.8个月vs12.1个月,P=0.016）。COX多因素回归分析结果示,是否行放疗既可作为影响SCLC患者PFS的独立预后因素（HR=0.488,95%CI=0.303～0.787,P=0.003）,也可作为影响SCLC患者OS的独立预后因素（HR=0.314,95%CI=0.190～0.519,P=0.000）。而PLR水平仅作为影响SCLC患者PFS的独立预后因素（HR=1.538,95%CI=1.040～2.274,P=0.031）,但不能作为OS的独立预后因素（HR=1.323,95%CI=0.883～1.982,P=0.175）。结论 PLR可以反映SCLC患者预后,但不能作为独立预后因素。     

阿帕替尼联合放化疗治疗晚期头颈部鳞癌的前瞻性研究

目的 研究旨在探索阿帕替尼联合放化疗治疗晚期头颈部鳞癌的有效性和安全性。方法 37例患者在同步放化疗期间口服阿帕替尼250mg/d,直到放疗结束、经影像学评估为完全缓解、不可接受的不良反应或死亡。在所有具有完整基线和安全性数据的患者中评估基线特征、客观反应率(ORR)和不良反应事件。使用Kaplan-Meier法计算无进展生存(PFS)和总生存(OS)率,Cox模型进行预后影响因素分析。结果 ORR为85%(95%CI为72%~98%),中位PFS为17.9个月,2年OS率为62%(95%CI为48%~80%)。近期疗效为无效(HR=0.035,95%CI为0.02~0.652,P=0.025)是OS较差的独立影响险因素,近期疗效为无效(HR=0.104,95%CI为0.017~0.633,P=0.014)和淋巴细胞减少(HR=17.539,95%CI为2.040~150.779,P=0.009)是PFS较差的独立影响因素。常见不良反应(>60%)为淋巴细胞减少症(76%)、白细胞减少症(68%)和放射性黏膜损伤(65%)。最常见的治疗相关3级不良事件是淋巴细胞减少症(49%)。结论 阿帕替尼联合放化疗对头颈部鳞癌具有显著的抗肿瘤活性,不良反应可控。对于晚期患者,近期疗效和淋巴细胞减少可能是阿帕替尼联合放化疗疗效的预测因子。     

肺肉瘤样癌患者外周血中单核细胞与淋巴细胞比值的临床意义

目的：探讨肺肉瘤样癌（pulmonary sarcomatoid carcinoma,PSC）患者外周血中单核细胞与淋巴细胞的比值（monocyte-to-lymphocyte ratio,MLR）与患者临床病理特征和预后的关系及其临床意义。方法：回顾性分析2010 年10 月至2017 年4 月天津市肿瘤医院80 例PSC患者的完整病例资料,采用受试者工作曲线（ROC）确定MLR预测OS的最佳临界值,将患者分为高和低MLR组,用Kaplan-Meier 方法计算得到OS并绘制生存曲线,Log-Rank 检验用于比较两组间OS的差别;将单因素有意义的变量带入COX风险回归模型验证、计算风险比（HR)及95%可信区间(95%CI)。结果：单核细胞、淋巴细胞中位绝对值分别为0.63×109/L、1.84×109/L,MLR最佳截点值为0.44。单因素分析显示,MLR≥0.44（P<0.01）、未行根治性手术（P<0.01）、临床分期Ⅲ+Ⅳ期（P<0.01）、肿瘤最大径>3 cm（P<0.05）、LDH>247 U/L（P<0.01）是影响OS 的不良预后因素。多因素分析显示,MLR≥0.44（HR=3.554;95%CI=1.671~6.125;P<0.01）、临床分期Ⅲ+Ⅳ期（HR=3.275;95%CI=2.047~9.399;P<0.01）是影响PSC患者OS的独立危险因素,根治性手术是影响PSC 患者OS的独立保护性因素（HR=0.360;95%CI=0.195~0.848;P<0.01）。结论：高MLR是PSC 患者不良预后的独立危险因素。     

术前血液学炎性反应标志物在胶质瘤患者预后中的价值

目的 探讨术前血液学炎性反应标志物（中性粒细胞与淋巴细胞比率（NLR）、单核细胞与淋巴细胞比率（MLR）和血小板与淋巴细胞比率（PLR））在胶质瘤患者临床预后中的预测价值。方法 纳入180例胶质瘤患者。应用ROC曲线确定NLR、MLR和PLR的最佳临床分界值并分组。变量组间比较采用χ²检验，通过Kaplan-Meier法和Log rank检验分析患者术后生存情况。Cox多因素回归分析预后因素。Pearson’s相关系数检验标志物间的相关性。结果 NLR、MLR和PLR的最佳分界值分别为1.90、0.33和133.38。高NLR和MLR组患者中位总生存期分别为16.8和14.8月，低NLR和MLR组分别为40.5和24.6月（均P<0.05）。高NLR组中位肿瘤复发时间为10.3月，低NLR组为28.8月（P=0.002）。NLR是胶质瘤患者的独立危险因素（HR=1.725, 95%CI: 1.042~2.853, P=0.034）。且NLR与MLR（r=0.62, P<0.001）和PLR（r=0.59, P<0.001）具有相关性。结论 术前高NLR、MLR与胶质瘤患者不良预后相关，且NLR是患者生存的独立预后因素，与肿瘤复发率密切相关。     

PLR、NLR对食管鳞癌放化疗/放疗患者预后的影响

目的 探讨治疗前血液炎性反应标志物：血小板与淋巴细胞比值、中性粒细胞与淋巴细胞比值对食管鳞癌放化疗/放疗患者预后的影响。方法 回顾性分析2012年3月至2017年11月在四川省肿瘤医院行放化疗/放疗并经病理诊断明确的143例ESCC患者的临床病理资料及随访资料。通过ROC曲线的约登指数分别确定血小板与淋巴细胞比值（PLR）和中性粒细胞与淋巴细胞比值（NLR）的界限值，并分别将患者分为高值组和低值组。χ2检验比较不同分组之间的差异，采用Kaplan-Meier法计算总生存，并采用log-rank test进行单因素分析，Cox回归模型进行多因素分析。结果 利用ROC曲线求得最佳PLR、NLR界值分别为196.67、3.55，低PLR组（<196.67）为120例，高PLR组（≥196.67）为23例；低NLR组（<3.55）为96例，高NLR组（≥3.55）为47例。放化疗/放疗前PLR和NLR水平与性别、年龄、肿瘤长度、T分期、N分期等临床病理特征均无关（P>0.05）。单因素分析显示T分期、N分期、治疗方式、PLR及NLR对ESCC患者的OS有影响（P<0.05）。多因素分析显示：PLR、治疗方式以及T分期是影响ESCC患者OS的独立预后因素（P<0.05），PLR比NLR更能预测ESCC患者预后。结论 PLR和NLR可预测ESCC患者的预后，PLR还可作为影响患者OS的独立预后因素。     

NLR和PLR动态变化预测PD-1/PD-L1治疗晚期非小细胞肺癌患者疗效及预后的价值

目的:探讨中性粒细胞-淋巴细胞比值(NLR)和血小板-淋巴细胞比值(PLR)在晚期非小细胞肺癌(aNSCLC)患者治疗前后的有效性及其对免疫应答的动态变化。方法:回顾性分析2018年1月至2019年5月在我院接受免疫治疗的60例aNSCLC患者。统计患者治疗前后NLR和PLR水平,分别记作NLR0、PLR0以及NLR12、PLR12,分析NLR、PLR及其动态变化对晚期NSCLC患者预后的价值。结果:在所有接受免疫治疗的aNSCLC患者中,47例患者治疗有效,无论是在基线还是治疗12周后,有效组的NLR和PLR水平均显著低于无效组;在多因素分析中,无论NLR0水平如何,NLR12高的患者无进展生存期(PFS)和总生存期(OS)较差,PLR的结果与NLR相似。结论:NLR12在预测患者免疫疗效及预后的价值高于NLR0,而NLR和PLR的动态变化可能更有助于预测aNSCLC患者的预后。     

Prognostic significance of neutrophil-to lymphocyte ratio and platelet-to lymphocyte ratio in older patients with metastatic colorectal cancer

Aging is associated with a higher risk of cancer, >70% of cancer-related deaths occur in aged patients; however, this population is underrepresented in clinical trials, therefore, clinical information regarding this age group is rather limited.ObjectivesNeutrophil-to lymphocyte ratio (NLR) and platelet-to lymphocyte ratio (PLR) have been described as biomarkers in cancer, thus, we have assessed their impact in an aged cohort of patients with metastatic colorectal cancer (mCRC).Patients and Methods110 patients with a mean age of 72.2 years at diagnosis were retrospectively reviewed; NLR and PLR were calculated and dichotomized using a cutoff point estimated by a ROC curve. Survival curves and Cox regression analysis were performed to assess the prognostic potential of ratios in terms of progression free survival (PFS) and overall survival (OS).ResultsHigh NLR was associated to worse outcome in terms of PFS (ten vs sixteen months; Log rank <0.001) (HR 2.00 95%CI 1. 29–3.11; p = .002) and OS (20 vs 26 months; Log rank 0.002) (HR 2.28 95%CI 1.40–3.71; p = .001). Similarly it occurs with high PLR and PFS (nine vs fifteen months; Log rank 0.04) (HR 1.55 95%CI 1.01–2.40; p = .04) and OS (nineteen vs 25 months; Log rank <0.001) (HR 2.35 95%CI 1.45–3.80; p < .001).ConclusionThis study confirms the role of NLR and PLR as accessible and noninvasive biomarkers that could be use as a routine tool in the clinical practice in geriatric patients with mCRC.     

Prognostic value of inflammation-based markers in patients with pancreatic cancer administered gemcitabine and erlotinib

AIM: To evaluate the value of systemic inflammation-based markers as prognostic factors for advanced pancreatic cancer (PC). METHODS: Data from 82 patients who underwent combination chemotherapy with gemcitabine and erlotinib for PC from 2011 to 2014 were collected retrospectively. Data that included the neutrophil-to-lymphocyte ratio (NLR), the platelet-to-lymphocyte ratio, and the C-reactive protein (CRP)-to-albumin (CRP/Alb) ratio were analyzed. Kaplan-Meier curves, and univariate and multivariate Cox proportional hazards regression analyses were used to identify the prognostic factors associated with progression-free survival (PFS) and overall survival (OS). RESULTS: The univariate analysis demonstrated the prognostic value of the NLR (P = 0.049) and the CRP/Alb ratio (P = 0.047) in relation to PFS, and a positive relationship between an increase in inflammation-based markers and a poor prognosis in relation to OS. The multivariate analysis determined that an increased NLR (hazard ratio = 2.76, 95%CI: 1.33-5.75, P = 0.007) is an independent prognostic factor for poor OS. There was no association between the PLR and the patients’ prognoses in those who had received chemotherapy that comprised gemcitabine and erlotinib in combination. The Kaplan-Meier method and the log-rank test determined significantly worse outcomes in relation to PFS and OS in patients with an NLR > 5 or a CRP/Alb ratio > 5. CONCLUSION: Systemic inflammation-based markers, including increases in the NLR and the CRP/Alb ratio, may be useful for predicting PC prognoses.     

Preoperative NLR and PLR in the middle or lower ESCC patients with radical operation

Neutrophil lymphocyte ratio (NLR) and platelet lymphocyte ratio (PLR) had been analysed in many kind of tumours, but its role of predict the oesophageal squamous cell carcinoma (ESCC) patients’ prognosis was not reach a consensus. Relationship between NLR, PLR and ESCC located in the middle or lower segment was evaluated. 317 patients with ESCC who underwent attempted curative oesophagectomy were analysed in this study. 157 and 98 patients had elevated NLR and PLR respectively (NLR >3.3 and PLR >150). The median overall survival time (OS) and disease‐free survival (DFS) was 34.1 and 19.2 months respectively. Multivariate analysis found PLR >150 (P = 0.018, HR 1.426, 95%CI 1.063–1.912) accompanied by male, lymphatic metastases, tumour size more than 3 cm, tumour located at middle segment and poor differentiation were associated with significantly worse DFS. Meanwhile, gender, lymphatic metastases, tumour location and differentiation along with PLR >150 (P = 0.003, HR 1.595, 95% CI 1.172–2.170) and NLR>3.3 (P = 0.039, HR 1.367, 95% CI 1.015–1.840) were all independent prognostic factors for OS. Preoperative NLR and PLR might be used as predictive factors in patients with ESCC. For DFS, elevated PLR compared to NLR may have an advantage to indicate poor prognosis.     

血小板-淋巴细胞比值在鼻咽癌预后预测中的作用：Meta分析

背景与目的：已发现血小板-淋巴细胞比值（platelet-to-lymphocyte ratio,PLR）可预测鼻咽癌的临床结果。然而,先前关于PLR与鼻咽癌预后的报道不一致。根据Meta分析提供更准确的预后评估。方法：检索了PubMed、Web of Science和Scopus数据库确定评估治疗前PLR在鼻咽癌中的预后作用的研究。终点是总生存期（overall survival,OS）、无进展生存期（progression-free survival,PFS）、疾病特异性生存率（disease-specific survival,DSS）、无远处转移生存期（distant metastasis-free survival,DMFS）。提取风险比（hazard ratio,HR）和95%置信区间（confidence interval,CI）,并根据异质性检验选用固定效应模型或随机效应模型估计每个终点的合并HR。结果：共纳入10项研究,涉及4 655例鼻咽癌患者。Meta分析汇总结果显示,升高的治疗前PLR与鼻咽癌患者较差的OS（HR=1.92,95% CI：1.73~2.14,P＜0.01）、PFS（HR=1.56,95% CI：1.19~2.06,P=0.002）及DSS（HR=1.65,95% CI：1.19~2.27,P=0.002）相关,但与DMFS无显著相关性（HR=1.69,95% CI：0.97~2.96,P=0.06）。结论：升高的治疗前PLR可以预测鼻咽癌患者更差的OS、PFS和DSS,而对DMFS没有预测价值。     

Combination of Platelet-Lymphocyte Ratio and Monocyte-Lymphocyte Ratio as a New Promising Prognostic Factor in Upper Tract Urothelial Carcinoma With Large Tumor Sizes > 3 cm

PurposeThe purpose of this study was to evaluate the prognostic values of pathological tumor size and preoperative blood-based inflammation biomarkers, including the neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and monocyte-lymphocyte ratio (MLR), in upper tract urothelial carcinoma (UTUC).Materials and MethodsFrom 2007 to 2017, retrospective data of 449 patients with UTUC who underwent radical nephroureterectomy were assessed. Use of Kaplan-Meier and univariable/multivariable analyses evaluated the effect of preoperative blood-based inflammation biomarkers on overall (OS), cancer-specific (CSS), and progression-free survival (PFS) in pathological tumor sizes > and ≤3 cm.ResultsKaplan-Meier analyses showed that high-level NLR, PLR, or MLR had significantly shorter OS, CSS, and PFS for tumor sizes >3 cm (all P < .05), but not for ≤3 cm. For UTUCs with tumor sizes >3 cm, multivariable analyses showed simultaneously high-level PLR and MLR to be independent predicators of poor OS, CSS, and PFS (all P < .05). Moreover, receiver operating characteristic (ROC) analyses revealed that the predictive accuracy of the combination of PLR and MLR for OS, CSS, and PFS with the area under the ROC curve of 0.836, 0.871, and 0.806, respectively, in tumor sizes >3 cm (all P < .001).ConclusionsOur study demonstrated that a high-level PLR and MLR can serve as an independent predicator of worse outcomes in UTUCs with tumor sizes >3 cm. This combination can clinically help enhance the prognostic discrimination of UTUCs with tumor sizes >3 cm and further may guide physicians in selecting patients for postoperatively systemic chemotherapy.     

Prognostic Value of Baseline Neutrophil-Lymphocyte and Platelet-Lymphocyte Ratios in Local and Advanced Gastric Cancer Patients

Background: We aimed to investigate the prognostic value of baseline neutrophil, lymphocyte, and plateletcounts along with the neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) in local andadvanced gastric cancer patients. Materials and Methods: In this retrospective cross-sectional study, a total of103 patients with gastric cancer were included. For all, patient characteristics and overall survival (OS) timeswere evaluated. Data from a complete blood count test including neutrophil, lymphocyte, monocyte, white bloodcell (WBC) and platelet (Plt) count, hemoglobin level (Hb) were recorded, and the NLR and PLR were obtainedfor every patient prior to pathological diagnosis before any treatment was applied. Results: Of the patients, 53had local disease, underwent surgery and were administered adjuvant chemoradiotherapy where indicated. Theremaining 50 had advanced disease and only received chemotherapy. OS time was 71.6±6 months in local gastriccancer patients group and 15±2 months in the advanced gastric cancer group. Univariate analysis demonstratedthat only high platelet count (p=0.013) was associated with better OS in the local gastric cancer patients. Incontrast, both low NLR (p=0.029) and low PLR (p=0.012) were associated with better OS in advanced gastriccancer patients. Conclusions: This study demonstrated that NLR and PLR had no effect on prognosis in patientswith local gastric cancer who underwent surgery and received adjuvant chemoradiotherapy. In advanced gastriccancer patients, both NLR and PLR had significant effects on prognosis, so they may find application as easilymeasured prognostic factors for such patients.     

Preoperative neutrophil:lymphocyte and platelet:lymphocyte ratios predict endometrial cancer survival

Background:

Variations in systemic inflammatory response biomarker levels have been associated with adverse clinical outcome in various malignancies. This study determined the prognostic significance of preoperative neutrophil:lymphocyte (NLR), platelet:lymphocyte (PLR) and monocyte:lymphocyte (MLR) ratios in endometrial cancer.

Methods:

Clinicopathological and 5-year follow-up data were obtained for a retrospective series of surgically treated endometrial cancer patients (n=605). Prognostic significance was determined for overall (OS) and cancer-specific survival (CSS) using Cox proportional hazards models and Kaplan–Meier analysis. Receiver–operator characteristic and log-rank functions were used to optimise cut-offs. NLR, PLR and MLR associations with clinicopathological variables were determined using non-parametric tests.

Results:

Applying cut-offs of ⩾2.4 (NLR), ⩾240 (PLR) and ⩾0.19 (MLR), NLR and PLR (but not MLR) had independent prognostic significance. Combining NLR and PLR scores stratified patients into low (NLR-low and PLR-low), intermediate (NLR-high or PLR-high) and high risk (NLR-high and PLR-high) groups: multivariable hazard ratio (HR) 2.51; P<0.001 (OS); HR 2.26; P<0.01 (CSS) for high vs low risk patients. Increased NLR and PLR were most strongly associated with advanced stage (P<0.001), whereas increased MLR was strongly associated with older age (P<0.001).

Conclusion:

Both NLR and PLR are independent prognostic indicators for endometrial cancer, which can be combined to provide additional patient stratification.     

放疗前中性粒细胞/淋巴细胞血小板/淋巴细胞预后营养指数及CA19-9与胰腺腺癌放疗后预后关系的分析

  目的  探讨胰腺癌患者放疗前外周血中性粒细胞与淋巴细胞的比值（neutrophil to lymphocyte ratio,NLR）、血小板与淋巴细胞的比值（platelet to lymphocyte ratio,PLR）、预后营养指数（prognostic nutritional index,PNI）及糖类抗原19-9（carbohydrate antigen 19-9,CA19-9）与总生存时间（overall survival,OS）关系。  方法  回顾性分析2008年3月~2013年3月空军总医院61例经病理确诊为胰腺腺癌的患者临床资料,并通过电子病历查询患者治疗前检验结果,通过电子病历记录或电话随访获得患者OS。采用Ka? plan-Meier方法构建生存曲线,组间差异比较用Log-rank检验,单因素及多因素的分析运用Cox比例风险模型进行。  结果  利用log-rank检验及单因素回归分析,提示NLR、PLR、CA19-9增高、PNI降低、TNM分期晚,患者生存期短,差异具有统计学意义。多因素回归分析显示,NLR（P=0.029,OR 2.344,95%CI:1.090~5.041）;PNI（P=0.026,OR 0.477,95%CI:0.248~0.917）是胰腺癌患者OS的独立影响因素。  结论  NLR、PLR、PNI等是评价胰腺癌患者预后较为简单、有效的可靠指标之一.