局部晚期下咽癌患者放疗前NLR与PLR对预后的意义

  目的  分析放疗前外周血中性粒细胞与淋巴细胞比值(NLR)和血小板与淋巴细胞计数比(PLR)对局部晚期下咽鳞状细胞癌患者的预后评估价值。  方法  回顾性分析2017年2月—2018年12月蚌埠医学院第一附属医院放疗科收治的27例接受单纯放疗、序贯放化疗或同步放化疗下咽癌患者的临床以及随访资料。通过建立受试者工作特征曲线，获得最佳界值，根据界值将患者分为高NLR组、低NLR组以及高PLR组、低PLR组，分析患者放疗前外周血NLR和PLR与临床病理特征及预后的相关性，通过Kaplan-Meier法绘制患者的生存曲线，log rank法比较患者的预后，通过Cox比例风险回归模型进行多因素分析。  结果  27例患者中，有10例患者生存，中位随访时间为34个月，中位生存时间为21个月。放疗前NLR的最佳界值为2.30，PLR的最佳界值为131.46。放疗前高NLR组和低NLR组患者的2年总生存率分别为18.8%和45.5%(P=0.006)。放疗前高PLR组和低PLR组患者的2年总生存率分别为18.8%和45.5%(P=0.040)。Log rank单因素分析显示肿瘤临床分期、治疗方式、放疗前NLR和放疗前PLR与患者的总生存有关(均P < 0.05)。多因素分析结果显示，肿瘤临床分期和治疗方式为影响患者总生存的独立因素。  结论  放疗前NLR、PLR升高对于接受放疗的下咽癌患者可能是预后不良的影响因素，但仍需进一步深入研究。 

Prognostic value of pretreatment neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio in patients with locally advanced hypopharyngeal cancer treated with radiation

  Objective  To evaluate retrospectively the prognostic value of pretreatment neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) in patients with locally advanced hypopharyngeal cancer treated with radiotherapy.  Methods  Twenty-seven patients who received radiotherapy alone, sequential chemoradiotherapy or concurrent chemoradiotherapy for locally advanced hypopharyngeal cancer in our hospital from February 2017 to December 2018 were retrospectively analysed. The patients were divided into two groups: high (NLR group/low NLR group and high PLR group/low PLR groups. Appropriate cut-off points were determined via the receiver operating characteristic curve(ROC) method. The survival curve was established via the Kaplan-Meier method. The survival of the two groups was compared via log-rank test. Multivariate Cox regression analysis was conducted by.  Results  Among the 27 patients, 10 patients were still alive. The median follow-up time was 34 months, and the median survival time was 21 months. The best cut-off value of NLR and PLR before radiotherapy was 2.30 and 131.46, respectively. The 2-year overall survival rates of patients in the high NLR and the low NLR groups before radiotherapy were 18.8% and 45.5%, respectively (P=0.006). The 2-year overall survival rates of patients in the high PLR and the low PLR groups before radiotherapy were 18.8% and 45.5%, respectively (P=0.040). Log rank single-factor analysis revealed that tumour clinical stage, treatment and NLR/PLR ratio before radiotherapy were related to the overall survival of patients (all P < 0.05). Multivariate analysis showed that tumour clinical stage and treatment were independent factors affecting the overall survival of patients.  Conclusion  An increase in NLR/PLR ratio before radiotherapy may affect the prognosis of patients with hypopharyngeal cancer. However, the sample size of this study was small. Thus, further research is needed.