术前NLR PLR 与乳腺癌预后的相关性

目的：研究外周血中中性粒细胞和淋巴细胞绝对值的比值（neutrophil to lymphocyte ratio ,NLR ）、血小板和淋巴细胞绝对值的比值（platelet to lymphocyteratio ratio ,PLR ）与乳腺癌预后的相关性。方法：收集2011年1 月至2014年12月延边大学附属医院316 例行乳腺癌根治术患者的临床病理资料,分析NLR 、PLR 与乳腺癌TNM 分期、雌激素受体、HER-2 及三阴性乳腺癌之间的关系。结果：NLR 与乳腺癌TNM 分期之间有相关性（P < 0.05）、与乳腺癌雌激素受体、HER-2 及三阴性乳腺癌之间无相关性（P > 0.05）,PLR 与乳腺癌TNM 分期及雌激素受体、HER-2 及三阴性乳腺癌之间均无相关性（P > 0.05）。 结论：术前NLR 水平作为全身炎症反应的指标可有效预测乳腺癌的预后。     

术前NLR、PLR与三阴性乳腺癌患者预后的相关性分析

目的:探讨术前外周血中性粒细胞与淋巴细胞计数比值(NLR)联合血小板与淋巴细胞计数比值(PLR)对三阴性乳腺癌(TNBC)患者预后的评估价值。方法:收集155例TNBC患者，根据NLR水平分为低NLR组和高NLR组，根据PLR水平分为低PLR组和高PLR组，分别分析NLR和PLR与TNBC患者临床特征和预后的关系，采用χ2检验进行影响患者预后的单因素分析，Kaplan-Meier法绘制生存曲线，Cox回归模型分析影响患者预后的独立危险因素。结果:术前外周血NLR与TNBC患者的淋巴结转移、病理分期及复发转移有关(P＜0.05)，与年龄、肿瘤大小、组织学分级及月经均无关(P＞0.05)。PLR与TNBC患者的临床特征无关(P＞0.05)。单因素分析结果显示:淋巴结转移、病理分期、NLR、复发转移与患者的3年无病进展期相关。Cox回归模型多因素分析结果显示，病理分期、淋巴结转移、NLR是影响TNBC患者预后的独立风险因素。结论:NLR与 TNBC患者的病理分期、淋巴结转移及复发转移密切相关，高NLR可作为判断患者预后的独立危险因素；PLR与TNBC患者的临床特征及预后无明显相关性。     

外周血常见炎性反应指标与非小细胞肺癌预后相关性的研究进展

肺癌是一种发病率高、预后差的恶性肿瘤,其中非小细胞肺癌占多数。瘤体除发生解剖学变化之外,可在体内出现其他的进展指征,通过监测这些指征可及早了解病情。炎性反应与非小细胞肺癌的发生发展密切相关,以常见的外周血细胞及C反应蛋白为基础的炎性反应指标具有较好的预后价值。本文通过针对临床外周血常见炎性反应指标在非小细胞肺癌患者中的预后价值进行文献梳理,科学、全面、客观地了解其研究现状,为临床决策提供一定的证据支持。     

与乳腺癌预后相关的生物学指标研究进展

乳腺癌是我国女性恶性肿瘤中的常见类型,近年来发病率呈直线上升趋势.根据上海市的统计,发病率已从1972年的17/10万上升至1993年的37/10万,成为女性恶性肿瘤之首.近年来随着新技术、新方法的开展,从细胞、分子水平等多层次检测乳腺癌细胞的生物学特性,了解肿瘤的恶性程度,为预测患者的预后、选择合适的辅助治疗方法、提高治愈率提供了更为有效的依据.现将与乳腺癌预后有关指标的研究进展综述如下.     

炎性反应参数评估壶腹癌预后生存的研究进展

壶腹癌作为一种罕见的消化道恶性肿瘤。相对于其他壶腹周围恶性肿瘤,其预后生存明显较好,但部分壶腹癌患者预后疗效仍不尽人意。研究证实全身炎性反应与肿瘤预后疗效密切相关,并且肿瘤微环境对肿瘤的进展和预后生存具有至关重要的作用。近年来,炎性反应参数及相关预测模型成为预测壶腹癌预后生存的热点,并已被证实具有一定的预测价值。本文就炎性反应参数与壶腹癌预后相关性及未来可能的研究进展进行概述。     

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。     

乳腺癌预后指标的临床意义

了解乳腺癌各种不同预后因素的价值，不仅可以判断患者的预后，而且可以预测治疗效果。及时给予恰当的治疗，对提高患者生存率有着重要意义。     

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。     

乳腺癌骨转移患者预后相关因素

乳腺癌是世界范围内女性最常见的恶性肿瘤,高达75%的患者最终会发生骨转移。骨转移发生风险与肿瘤分子分 型、组织病理和患者生理阶段等密切相关,骨转移合并其他部位转移、发生骨相关事件、骨转移灶的特点等都可影响患者的预后。 目前临床广泛应用的骨转移治疗方法包括全身应用抗肿瘤药物和骨改良药物、局部行骨转移灶放疗和骨转移灶手术。除抗肿瘤 药物外的其他治疗手段都有望改善患者预后。近年来发展的骨转移治疗新手段,如对乳腺癌原发灶的处理、放射性物质镭、骨转 移关键信号分子抑制剂和某些新技术应用在提高患者生存方面都有良好的前景。本文就乳腺癌骨转移患者的预后相关因素作 简要综述。     

Prognostic Significance of Inflammation-associated Blood Cell Markers in Nonmetastatic Clear Cell Renal Cell Carcinoma

ObjectivesOur objective was to evaluate the effect of the neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), lymphocyte/monocyte ratio (LMR), and red blood cell distribution width (RDW) on the survival outcomes of nonmetastatic clear cell renal cell carcinoma (ccRCC).Materials and MethodsWe accessed our single-center, urologic-oncologic registry to extract the data for patients who had undergone nephrectomy for nonmetastatic ccRCC. The optimal cutoff for these markers was determined using X-tile software, and survival analyses using Cox regression were performed.ResultsA total of 687 patients had undergone nephrectomy. The optimal cutoffs for NLR, PLR, LMR, and RDW were 3.3, 210, 2.4, and 14.3%, respectively. The NLR, PLR, LMR, and RDW were significantly associated with a larger pathologic tumor size, and stage, more aggressive Fuhrman grade, and the presence of tumor necrosis. After adjusting for age, baseline Eastern Cooperative Oncology Group, pathologic tumor and nodal stage, and Fuhrman grade, only PLR remained an independent prognostic marker for both cancer-specific survival (hazard ratio, 2.69; 95% confidence interval, 1.36-5.33; P = .004) and overall survival (hazard ratio, 2.19; 95% confidence interval, 1.36-3.50; P = .001). When the PLR was included with the Leibovich score and University of California, Los Angeles, integrated staging system, the Harrell’s c-index increased from 0.854 to 0.876 and 0.751 to 0.810, respectively, for cancer-specific survival at 5 years after nephrectomy. When risk stratified by the Leibovich risk group and UCLA integrated staging system, PLR was a significant prognostic factor only within the intermediate- to high-risk groups.ConclusionsPLR is a robust prognostic marker in nonmetastatic ccRCC that clearly outperforms other inflammatory indexes in those who had undergone nephrectomy. However, its prognostic effect was limited in the low-risk category of ccRCC.     

Diagnostic and Prognostic Importance of the Neutrophil Lymphocyte Ratio in Breast Cancer

Background: The aim of this study was to determine diagnostic and prognostic roles of the neutrophil tolymphocyte ratio (NLR) in breast cancer patients. To date, data are limited on associations of primary breastcarcinoma (PBC) and benign proliferative breast disease (BPBD) with preoperative NLR values. Materials andMethods: Our study covered of 120 female patients with PBC and 50 with BPBD. Diagnostic values of NLRwere estimated using sensitivity, specificity and areas under receiver operating characteristic curves (AUC).Results: NLR values were significantly higher in the PBC patients than in those with BPBD, with an AUC of0.668 in the PBC case. The optimal cut-off for NLR was 2.96 and this was validated in the testing set, giving asensitivity and a specificity of 79.7% and 76.2%, respectively, in PBC patients. Conclusions: Preoperative highNLR is a significant diagnostic predictor of distinction of breast cancer from BPBD and elevated NLR is alsoan important prognostic marker for primary invasive breast cancer.     

Prognostic significance of preoperative inflammatory response biomarkers in patients undergoing curative thoracoscopic esophagectomy for esophageal squamous cell carcinoma

Background

Recent studies have revealed significant relationships between the lymphocyte-to-monocyte ratio (LMR), neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR) and survival in various cancers. The purpose of this study was to confirm whether the LMR, NLR, and PLR have prognostic values, independent of clinicopathological criteria, in patients undergoing curative resection for esophageal cancer.

炎性乳腺癌48例临床分析

目的探讨炎性乳腺癌的临床特点，治疗及预后因素，方法对４８例炎性乳腺癌的临床资料进行回顾性分析，按ＴＮＭ分期，Ⅲｂ期３８例，Ⅳ期１０例，无特定的组织学类型；４８例者均接受综合治疗。结果全组病例平均生存期为３２个月，３年生存率为４５．８％，５年生存率为３３．３％；Ⅲｂ期生存５年者有１６例，Ⅲｂ期１年内死亡者有５例，Ⅳ期１０例中有６例在１年内死亡。结论炎性乳腺癌的治疗主要为诱导化疗、手术、局部放疗及辅助     

Predictive Value of Hematological Inflammatory Markers in Endometrial Neoplasia

Objective: To investigate the predictive role of neutrophil lymphocyte ratio (NLR) and the platelet lymphocyte ratio(PLR) as hematological inflammatory markers in cases of endometrial hyperplasia and cancer. Material and Method:This retrospective study was performed between 2005-2015 with 247 cases of 83 endometrial adenocarcinoma (group1), 64 of endometrial hyperplasia (group 2) and 100 controls (group 3) who underwent a curettage due to abnormaluterine bleeding and had a normal histopathology in our tertiary clinic. The cases were chosen from patients withoutchronic diseases, that do not have infection or medication that could affect the systemic inflammatory response. Preinterventionblood parameters were taken into account. The neutrophil/ lymphocyte and platelet/lymphocyte ratios wereand statistical comparisons of the groups were conducted. Results: The age distribution of 247 patients was between26 and 85 years, and the mean age was 48.8 ± 8.92.The median age was 54 in group 1, 46 in group 2 and 45 in group 3.The age was significant between group 1 and the other groups (p=0.001). Some 71% of the cases were premenopausaland 29% were postmenopausal, the latter being significantly more frequent in group 1 (62.7%; p=0.001). Of the caseswith endometrial hyperplasia, 42 (65.6%) had simple and 22 (34.4%) have atypical-complex lesions. The medianNLRs in groups 1, 2, and 3 were 2.15, 2.10, and 1.92, respectively, with median PLRs of 135.1, 134.0 and 145.6.There was a statistically significant difference between the NLR measurements of the cases from different groups(p=0.048; p<0.05). The NLR value for the endometrial adenocarcinoma group was significantly higher than for thecontrol group (p=0.033; p<0.05). The optimum cut-off value was calculated to be ≥4, at which sensitivity was 20.5%,specificity 99%, positive predictive value (PPV) 94.4% and negative predictive value (NPV) 60%. Conclusion: Thevalue of NLR ≥4 has predictive significance in distinguishing endometrial pathologies before intervention in patientswith abnormal uterine bleeding. Simple, cheap and easy-to-perform, the NLR can be used as a potential hematologicalmarker for endometrial malignancy.     

外周血中性粒细胞与淋巴细胞比率和血小板与淋巴细胞比率与乳腺癌新辅助化疗患者预后的关系

目的评价乳腺癌患者新辅助化疗(NAC)前外周血中性粒细胞与淋巴细胞比率(NLR)和血小板与淋巴细胞比率(PLR)与其DFS的关系。 方法回顾性分析2013年1月至2015年3月期间在重庆医科大学附属第一医院确诊并接受NAC的283例乳腺癌患者临床资料。分别将约登指数最大值对应的NLR值和PLR值作为截断值,按≥截断值和<截断值分为高、低比值组。采用Log-rank检验和Cox比例风险回归模型分析患者治疗前外周血NLR和PLR水平与其DFS的关系。 结果约登指数最大值对应的NLR值和PLR值分别为1.8和130.0,以之为截断值,将患者分为高NLR(≥1.8)组180例和低NLR(<1.8)组103例,以及高PLR(≥130.0)组130例和低PLR(<130.0)组153例。中位随访30个月(5～46个月),高NLR组患者中位DFS较低NLR组短(27.0个月比34.0个月,Log-rank检验：χ²＝26.25,P<0.001);高PLR组患者中位DFS较低PLR组短(27.5个月比32.0个月,Log-rank检验：χ²＝28.32,P<0.001)。在NAC后未达到pCR的239例患者中,高NLR组患者(n＝161)DFS较低NLR组(n＝78)差(HR＝2.84,95%CI＝1.43～4.45,P＝0.002),高PLR组患者(n＝118)DFS也较低PLR组(n＝121)差(HR＝2.62,95%CI＝1.51～4.61,P＝0.001)。多因素Cox比例风险回归分析显示,有生育史(HR＝3.90,95%CI＝1.28～11.87,P＝0.016)和高PLR(HR＝1.01,95%CI＝1.00～1.02,P＝0.004)是接受NAC的乳腺癌患者DFS的不良预后因素,而高NLR不是独立预后影响因素。 结论乳腺癌患者NAC前外周血高水平NLR和PLR预示其预后较差,PLR为独立危险因素。     

组织蛋白酶D对乳腺癌预后的意义

用免疫组化法检测了55例乳腺癌患者的组织蛋白酶D（CathD）。肿瘤实质CathD阳性者16例（29．09％），间质高表达者26例（47．27％），CathD实质表达与组织学分级低（P＜0．025）、增殖细胞核抗原（PCNA）低表达（P＜0．025）相关，与无病生存（P＞0．10）和总生存期（P＞0．10）无显著关系；CathD间质高表达与组织学分级高（P＜0．025）、淋巴结转移（P＜0．025）、PC-NA高表达（P＜0．025）及短的无病生存期（P＜0．005）和总生存期（P＜0．005）相关。提示CathD间质表达能预测复发和总生存期，检测CathD对乳腺癌的辅助治疗可有帮助。     

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.     

Ki67在乳腺癌中的表达水平及其对新辅助化疗患者预后的评估价值

目的研究Ki67表达水平对乳腺癌新辅助化疗后患者预后的评估价值。方法调取行乳腺癌新辅助化疗的120例患者的临床资料,并对其临床病理指标、Ki67的表达及预后进行回顾性分析。结果乳腺癌患者的病理有效率与月经状态、病理组织学类型、雌激素受体状态无关,与原发肿瘤大小、淋巴结转移情况有关(P<0.01)。新辅助化疗后患者的Ki67阳性表达率与化疗前相比显著降低(P<0.01);在病理有效率方面,化疗前Ki67高表达组经新辅助化疗后有效率明显高于Ki67低表达组,差异具有统计学意义(χ~2=19.00,P<0.01);Ki67表达化疗前后明显下降组的病理有效率明显高于轻度下降组病理有效率,差异具有统计学意义(χ~2=89.68,P<0.01)。结论 Ki67呈高表达状态时提示乳腺癌患者新辅助化疗效果良好,同时其表达变化也可对患者的病情进行有效的评估。     

BMP-12在乳腺癌中的异常表达及潜在预后价值

目的 探讨BMP-12在乳腺癌中的表达情况及与其预后的相关性.方法 RT-PCR检测BMP-12 mRNA在乳腺癌细胞株中的表达情况;BMP-12在肿瘤原发病灶(n=108)和正常乳腺组织(n=29)中的表达情况采用实时定量PCR进行检测;免疫组化检测BMP-12蛋白在正常组织和乳腺癌组织中的表达情况.结果 与正常乳腺组织和细胞系相比,BMP-12 mRNA在乳腺癌组织和乳腺癌细胞株中的表达水平下调;免疫组化显示BMP-12蛋白在乳腺癌组织中的表达水平较正常组织明显降低;预后好的乳腺癌患者BMP-12 mRNA表达水平较高;总生存期长患者比生存期短的患者BMP-12表达水平高.结论 BMP-12低水平表达与乳腺癌患者预后不良相关,BMP-12可能是乳腺癌的潜在预后指示因子.