非手术治疗的老年非小细胞肺癌患者外周血血小板/淋巴细胞比值与D-二聚体对预后的影响

目的:探究70岁以上非手术治疗的老年非小细胞肺癌（non-small cell lung cancer，NSCLC）患者治疗前外周血的血小板/淋巴细胞比值（platelet-to-lymphocyte ratio,PLR）与D-二聚体（D-dimer,D-D）水平及意义，并分析其与临床病理特征及预后的相关性。方法:入组115例老年NSCLC患者，并选取50例老年健康体检者为对照组。检测两组患者治疗前的淋巴细胞、血小板、D-D水平，分别按年龄、性别、病理类型、肿瘤TNM分期、ECOG评分、吸烟指数、BMI、有无合并症、有无淋巴结转移进行分组,分析PLR和D-D水平在不同亚组中的差异。 结果:老年NSCLC患者治疗前外周血中PLR、D-D水平均高于对照组（P＜0.001）。PLR值与TNM分期、ECOG评分、BMI、有无基础疾病、是否合并淋巴结转移有关（P＜0.05）；而D-D则与TNM分期、ECOG评分、有无淋巴结转移有关（P＜0.05）；PLR、D-D水平与OS呈负相关（P＜0.05）。结论:70岁以上老年NSCLC患者治疗前外周血中PLR、D-D水平越高，生存期越短，预后越差，提示PLR、D-D可能作为非手术治疗的老年NSCLC患者预后的预测指标。

Influence of peripheral platelet-to-lymphocyte ratio and D-dimer on prognosis in elderly patients with non-surgical non-small cell lung cancer

Objective:To explore the platelet-to-lymphocyte ratio (PLR) and D-dimer levels and significance in peripheral blood of non-surgical non-small cell lung cancer (NSCLC) patients aged over 70 years before treatment,analyzing its correlation with the clinicopathological characteristics and prognosis.Methods:A total of 115 elderly patients with NSCLC were enrolled,and 50 elderly healthy patients were selected as the control group.The pre-treatment levels of lymphocytes,platelets and D-D in different groups were tested,and the differences of PLR and D-D in the elderly lung cancer group and the control group were analyzed by age,gender,pathological type,TNM staging of tumors,ECOG score,smoking index,body mass index (BMI),presence of complications and lymph node metastasis.Results:The levels of PLR and D-D in peripheral blood of elderly NSCLC patients before treatment were higher than those in the control group (P＜0.001).The PLR levels were related to TNM staging,ECOG score,BMI,underlying diseases and lymph node metastasis (P＜0.05).The levels of D-D were associated with TNM stage,ECOG score and lymph node metastasis (P＜0.05).PLR and D-D levels were negatively correlated with overall survival (P＜0.05).Conclusion:The pre-treatment PLR and D-D levels of NSCLC patients over 70 years old were associated negatively with the prognosis and survival period,suggesting that the PLR and D-D levels may be used as a prognostic indicator for non-surgical elderly NSCLC patients.