术前纤维蛋白原联合中性粒细胞与淋巴细胞比值评分与非小细胞肺癌临床病理特征及预后的关系

目的探讨术前纤维蛋白原 (fibrinogen，Fbg) 联合中性粒细胞与淋巴细胞比值（neutrophil to lymphocyte ratio，NLR）评分（COF NLR）与非小细胞肺癌（non small cell lung cancer，NSCLC）患者临床病理特征及预后的相关性。方法回顾性分析我院行根治性手术切除且具有完整信息的122例NSCLC患者的临床病理资料。根据COF NLR评分原则分为3组：COF NLR0分 49例，COF NLR1分41例，COF NLR2分32例。根据患者术前的Fbg及NLR水平，构建新的COF NLR参数。χ2检验分析其与患者临床病理因素的相关性，Kaplan Meier法进行单因素生存分析，Log rank法进行检验，Cox比例风险模型进行多因素回归分析。结果术前COF NLR水平与性别、分化程度、肿瘤位置、T分期、临床分期密切相关（P<0.05）；单因素分析结果显示吸烟史、肿瘤分化程度、T分期、有无淋巴结转移、Fbg、NLR水平、COF NLR评分是影响患者预后的因素（P<0.05），多因素分析表明分化程度（P<0.05）、淋巴结转移（P<0.05）及COF NLR（P<0.05）是影响患者预后的独立危险因素。结论NSCLC患者术前COF NLR水平升高与肿瘤进展具有相关性，提示患者预后不良；COF NLR可作为预测NSCLC患者肿瘤进展及预后的具有潜在应用价值的新指标。

Association of COF NLR with clinicopathological characteristics and prognosis ofpatients with non small cell lung cancer after curative resection

Objective To analyze the combination of preoperative plasma levels of fibrinogen(Fbg) and neutrophil to lymphocyte ratio (COF NLR) with clinicopathologic characteristics as well as the prognosis of non small cell lung cancer (NSCLC) patients after curative resection. Methods The clinical data of 122 patients with NSCLC who underwent curative resection in our hospital were retrospectively analyzed. A total of 122 patients with NSCLC were divided into three groups based on the criteria of COF NLR: COF NLR 0 group， n=49; COF NLR1 group， n=41; COF NLR2 group， n=32. The preoperative COF NLR was calculated by combing the fibrinogen and neutrophil to lymphocyte ratio (NLR). The relationship between the COF NLR and clinicopathological features was studied by chi square test. The postoperative prognostic factors were analyzed using univariate Kaplan Meier analysis and multivariate Cox proportional hazards model. Results The COF NLR was significantly associated with sex， differentiation degrees， T staging， clinical staging（P<0.05）. Univariate analysis showed smoking history， differentiation degrees， T staging， lymph node metastasis， plasma levels of fibrinogen，NLR and COF NLR were associated with survival (P<0.05). Multivariate analysis identified that differentiation degrees， lymph node metastasis and COF NLR as independent prognostic factors of all the patients(all P<0.05).Conclusion Preoperative elevated plasma level of COF NLR indicates tumor progression and poor prognosis in patients with NSCLC. The COF NLR may be a potentially new and useful blood marker for predicting tumor progression and the prognosis of patients with NSCLC.