术前NLR、PLR及RDW预测前列腺癌患者术后复发转移的价值

目的:探讨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）及红细胞分布宽度（red blood cell distribution width，RDW）对前列腺癌（prostate cancer，PCa）患者术后复发转移的价值。方法:选取2016年01月至2018年06月我院收治的PCa患者128例，根据其术后是否发生复发转移分为未复发转移组（n=78）和复发转移组（n=50）。采用Sysmex XN-3000全自动血细胞分析仪检测PCa患者NLR、PLR及RDW水平，分析其与临床病理特征的关系。应用受试者工作特征（receiver operating characteristic，ROC）曲线分析NLR、PLR及RDW预测PCa术后复发转移的价值。Pearson相关分析检测NLR、PLR及RDW之间的相关性。结果:复发转移组NLR（3.72±1.56 vs 2.38±1.14）、PLR（190.82±62.83 vs 158.42±43.70）及RDW［（13.85±1.24 ）% vs （12.74±0.96）%］水平均明显高于未复发转移组（P＜0.01）。复发转移患者NLR、PLR及RDW水平与TNM分期、Gleason评分及分化程度相关（P＜0.05）。ROC曲线分析显示，NLR、PLR及RDW预测PCa术后复发转移的最佳截值分别为3.06、181.42、13.28%，三项联合预测PCa术后复发转移的AUC（0.857，95%CI:0.795～0.916）最大，其敏感度和特异度为87.3%和82.0%。相关分析显示，复发转移患者NLR与PLR、RDW均呈正相关（r=0.758、r=0.625，P＜0.01），PLR与RDW呈正相关（r=0.548，P＜0.01）。结论:术前NLR、PLR及RDW水平升高与PCa术后复发转移有关，三项联合检测对预测PCa术后复发转移有一定的价值。

The value of preoperative NLR,PLR and RDW in predicting postoperative recurrence and metastasis in patients with prostate cancer

Objective:To explore the value of neutrophil to lymphocyte ratio(NLR),platelet to lymphocyte ratio(PLR)and red blood cell distribution width(RDW)in the recurrence and metastasis of prostate cancer(PCa)after operation.Methods:128 patients with PCa admitted to our hospital from January 2016 to June 2018 were divided into non-recurrence and metastasis group(n=78)and recurrence and metastasis group(n=50)according to their recurrence and metastasis after operation.The levels of NLR,PLR and RDW in PCa patients were measured by Sysmex XN-3000 automatic hematology analyzer,and their relationship with clinicopathological features was analyzed.Receiver operating characteristic(ROC)curves were used to analyze the value of NLR,PLR and RDW in predicting postoperative recurrence and metastasis of PCa.The correlation among NLR,PLR and RDW was detected by Pearson correlation analysis.Results:The levels of NLR(3.72±1.56 vs 2.38±1.14),PLR(190.82±62.83 vs 158.42±43.70)and RDW(13.85±1.24)%vs(12.74±0.96)%]in the recurrence and metastasis group were significantly higher than those in the non-recurrence and metastasis group(P<0.01).The levels of NLR,PLR and RDW in patients with recurrence and metastasis were correlated with TNM stage,Gleason score and differentiation degree(P<0.05).ROC curve analysis showed that the best cut-off values of NLR,PLR and RDW for predicting postoperative recurrence and metastasis of PCa were 3.06,181.42,13.28%,respectively.The AUC(0.857,95%CI:0.795~0.916)of postoperative recurrence and metastasis predicted by the three combination was the highest,with the sensitivity and specificity of 87.3%and 82.0%.The correlation analysis showed that NLR was positively correlated with PLR and RDW in patients with recurrence and metastasis(r=0.758,r=0.625,P<0.01),and PLR was positively correlated with RDW(r=0.548,P<0.01).Conclusion:Preoperative higher NLR,PLR and RDW levels are associated with postoperative recurrence and metastasis of PCa,and the three combined test is of certain value in predicting postoperative recurrence and metastasis of PCa patients.