术前NLR、PLR和MLR在胶质瘤患者预后中的应用研究

目的 探讨术前血液炎症指标中性粒细胞-淋巴细胞比(neutrophil-lymphocyte ratio，NLR)、血小板-淋巴细胞比(platelet-lymphocyte ratio，PLR)和单核细胞-淋巴细胞比(monocyte-lymphocyte ratio，MLR)在胶质瘤患者预后中的应用价值。 方法 回顾性分析2013年1月—2018年12月在南通大学附属医院接受治疗的236例脑胶质瘤患者的临床资料，通过ROC曲线、Kaplan-Meier生存曲线、单因素和多因素分析等方法评估术前NLR、PLR、MLR在胶质瘤患者预后的应用价值。 结果 术前NLR、PLR和MLR的表达均与肿瘤分级相关(均P＜0.05)，三者预测生存的最佳分界值分别为2.40、127和0.24，生存曲线显示高NLR组、高PLR组和高MLR组中位生存时间明显短于低NLR组、低PLR组和低MLR组(均P＜0.001)。多因素分析显示术前NLR为预测胶质瘤预后的独立危险因素(P=0.008)。 结论 术前血液炎症指标NLR检测方便、快捷，是影响胶质瘤患者预后的独立危险因素，具有重要的临床价值。 

Application of preoperative NLR,PLR and MLR in the prognosis of patients with glioma

Objective To assess the application value of preoperative blood inflammatory index neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR) and monocyte-lymphocyte ratio (MLR) in the prognosis of patients with glioma. Methods The clinical data of 236 patients with glioma treated at the Affiliated Hospital of Nantong University from January 2013 to December 2018 was analyzed retrospectively. The application value of preoperative NLR, PLR, MLR in prognosis of patients with glioma wad assessed by ROC curve, Kaplan-Meier survival curve, univariate and multivariate analysis. Results The expressions of NLR, PLR and MLR were correlated with tumor grade (all P<0.05). The best cutoff values for survival predict were 2.40, 127 and 0.24 respectively. The survival curve showed the median survival time in the high NLR group, high PLR group, and high MLR group was significantly shorter than that in the low NLR group, low PLR group, and low MLR group (all P<0.001). Multivariate analysis showed that preoperative NLR was an independent risk factor for predicting prognosis (P=0.008). Conclusion Preoperative blood inflammatory index NLR test is convenient and fast, which is an independent risk factor that affects the prognosis of glioma patients and has an important clinical value for prognosis of glioma patients.