外周血血小板与淋巴细胞比值在滤泡淋巴瘤预后中的价值

目的  探讨外周血血小板与淋巴细胞比值（platelet to lymphocyte ratio，PLR）与滤泡淋巴瘤（follicular lymphoma，FL）的预后的关系。方法 回顾性分析四川省肿瘤医院2006年2月至2016年12月收治的74例FL患者的临床资料，通过X-Tile　3.6.1软件计算PLR的截断值，并根据截断值将患者分为低PLR组（<186.8，n=59）和高PLR组（≥186.8，　n=15）。采用Cox回归分析PLR与预后的关系。结果 中位随访42个月（范围：6~144个月），4年无疾病进展生存（progression free survival，PFS）为42.0%，4年总生存（overall survival，OS）为54.7%。低PLR组的4年PFS较高PLR组长（51.3% vs 6.7%，χ²=25.320，P<0.001），4年OS亦较高PLR组长（65.7% vs 8.3%，χ²=29.414，P<0.001）。多因素Cox回归分析显示，PLR≥186.8是影响FL患者PFS（HR=3.949，95%CI：1.856~8.404，P<0.001）和OS（HR=4.795，95%CI：2.259~10.178，P<0.001）的独立危险因素。进一步分析发现，在低危FL患者中，低PLR组的中位PFS和中位OS均高于高PLR组（PFS：75.5个月 vs 19.0个月，χ²=14.798，P<0.001；OS：85.5个月 vs 28.0个月，χ²=13.271，P<0.001）。在中高危FL患者中，低PLR组的中位PFS和中位OS亦均高于高PLR组（PFS：32.0个月 vs 12.0个月，χ²=10.766，P=0.001；OS：51.0个月 vs 19.0个月，χ²=13.404，P<0.001）。结论 PLR与FL患者预后相关，ＰＬＲ高的ＦＬ患者的预后较差，可作为评估其预后的指标。

Prognostic value of peripheral blood platelet to lymphocyte ratio for follicular lymphoma

Objective  To explore the prognostic value of platelet to lymphocyte ratio（PLR） for follicular lymphoma（FL）. Methods The clinical data of 74 patients with FL admitted to Sichuan Cancer Hospital from February 2006 to December 2016 were retrospectively analyzed. The cutoff value of PLR was calculated by X-Tile 3.6.1 software，and the patients were divided into low PLR group（<186.8，n=59）and high PLR group（≥186.8，n=15） according to the cutoff value. Cox regression analysis was used to analyze the relationship between PLR and prognosis. Results The median follow-up of this study was 42 months（range：6-144 months），4 years of progression free survival （PFS） was 42.0%，and overall survival （OS） was 54.7%. The 4-year PFS of the low PLR group was longer than that of the PLR group（51.3% vs 6.7%，χ²=25.320，P<0.001），and the 4-year OS was also longer than the PLR group（65.7%  vs 8.3%， χ²=29.414，P<0.001）. Multivariate Cox regression analysis showed that PLR>186.8 was an independent risk factor for PFS（HR=3.949，95%CI：1.856-8.404，P<0.001） and OS（HR=4.795，95%CI：2.259-10.178，P<0.001）for FL patients. Further analysis demonstrated that in low risk FL patients group，median PFS and median OS of the low PLR group were significantly longer than those of the high PLR group（PFS：75.5 months vs 19.0 months，χ²=14.798，P<0.001；OS：85.5 months vs 28.0 months，χ²=13.271，P<0.001）. Similarly，in intermediate-high risk FL patients group，median PFS and median OS of the low PLR group were also significantly longer than those of the high PLR group （PFS：32.0 months vs 12.0 months，χ²=10.766，P=0.001；OS：51.0 months vs 19.0 months，χ²=13.404，P<0.001）. Conclusion PLR is associated with prognosis in patients with FL and can be used as an indicator of prognosis.