NLR、RDW-CV对合并COPD的NSCLC患者术后预后评估价值

目的评估术前中性粒细胞和淋巴细胞比值(NLR)、红细胞分布宽度变异系数(RDW-CV)对合并慢性阻塞性肺疾病(COPD)的非小细胞肺癌(NSCLC)患者预后临床价值。方法分析2011年1月至2014年8月159例在海口市人民医院行根治性手术的NSCLC患者临床病理资料,其中99例合并COPD。根据ROC曲线确定NLR、RDW-CV的最佳截点,分析NLR、RDW-CV与合并COPD的NSCLC患者预后的关系。结果合并COPD的NSCLC患者NLR水平显著高于不合并COPD的患者(P=0.003),而RDW-CV水平与是否合并COPD无关(P=0.83)。高NLR与淋巴结情况(P=0.001)、TNM分期(P=0.019)、吸烟(P=0.040)显著相关,高RDW-CV与肿瘤大小(P=0.047)显著相关。高NLR(P<0.001)与高RDW-CV(P=0.024)与患者的总生存期(OS)缩短相关,而且高NLR(P=0.022)、高RDW-CV(P=0.017)、肿瘤大小(P=0.004)、淋巴结情况(P=0.009)、是否吸烟(P=0.043)、FEV1/预计值%(P=0.005)是患者OS的独立危险因素。结论高NLR与高RDW-CV与合并COPD的NSCLC患者术后预后不良有关。

Value of NLR and RDW-CV in evaluating the postoperative prognosis of NSCLC patients complicated with COPD

Objective To evaluate the prognostic value of neutrophilic granulocyte/lymphocyte ratio(NLR)and RDW-CV in patients with non-small cell lung cancer(NSCLC)complicated with chronic obstructive pulmonary disease(COPD).Methods Retrospective analysis was performed on the clinicopathological data of 159 NSCLC patients who underwent radical surgery in HaiKou people's hospital from January 2011 to August 2014,99 of whom were complicated with COPD.The critical values of NLR and RDW-CV were determined according to the ROC curve analysis,and the relationship between NLR and RDW-CV and the prognosis of NSCLC patients with COPD was analyzed.Results The NLR level of NSCLC patients with COPD was significantly higher than that of patients without COPD(P=0.003),while the RDW-CV level was not significantly correlated with it(P=0.83).High NLR was significantly associated with lymph node status(P=0.001),TNM stage(P=0.019),smoking(P=0.04),and high RDW-CV level was significantly associated with tumor size(P=0.047).High NLR(P<0.001)and high RDW-CV(P=0.024)were associated with reduced overall survival(OS),and high NLR(P=0.022),high RDW-CV(P=0.017),tumor size(P=0.004),lymph node status(P=0.009),smoking(P=0.043),and FEV 1/normal estimate%(P=0.005)were independent risk factors for overall survival.Conclusion High NLR and high RDW-CV are associated with poor postoperative prognosis in NSCLC patients with COPD.