局部晚期鼻咽癌患者治疗前外周血乳酸脱氢酶/白蛋白比例与预后的相关性

目的:回顾性分析局部晚期鼻咽癌患者治疗前外周血中乳酸脱氢酶/白蛋白比例（lactate dehydrogenase to albumin ratio，LAR）与患者治疗后预后的相关性。方法:收集2014年06月至2018年12月之间收治入院的296例初治Ⅲ/Ⅳa，b期（AJCC第7版分期）鼻咽癌患者为研究对象，采用外周血中LAR中位值3.633为阈值对所有患者进行分层。分析局部晚期鼻咽癌患者治疗前外周血中LAR与总生存（OS）、无局部复发生存（LRFS）和无远处转移生存（DMFS）的相关性。结果:高LAR组(≥3.633)与年龄大（P=0.000)、死亡（P=0.000)相关；Cox风险模型分析显示LAR与局部晚期鼻咽癌患者的OS、LRFS、DMFS三者均存在相关性，LAR越高，预示着更差的OS、LRFS、DMFS。结论:局部晚期鼻咽癌患者治疗前外周血LAR水平是独立的不良预后因素，可用于风险分层及指导辅助治疗。

The correlation between peripheral lactate dehydrogenase to albumin ratio and prognosis in patients with locally advanced nasopharyngeal carcinoma

Objective:To evaluate the predictive value of peripheral blood lactate dehydrogenase to albumin ratio(LAR)in patients with locally advanced nasopharyngeal carcinoma(NPC).Methods:A total of 296 patients withⅢ/Ⅳ_a,b(AJCC 7th edition)nasopharyngeal carcinoma(NPC),who admitted in hospital between June 2014 to December 2018 were enrolled.We employed a threshold of pretreatment LAR=3.633(median)to stratify patients.The association between pretreatment LAR and curative effect before treatment and its effects on distant metastasis-free survival(DMFS),local recurrence-free survival(LRFS)and overall survival(OS)were analyzed.Results:HighLAR(≥3.633)was associated with advanced age(P=0.000)and deaths(P=0.000).Cox multivariate regression model showed that high LAR was an independent inferior prognostic factor for OS,LRFS,DMFS.Conclusion:Pretreatment LAR is an independent prognostic factor in locally advanced nasopharyngeal carcinoma and could be used in risk stratification and guiding adjuvant therapy.