中性粒细胞减少至最低值时间与局部晚期宫颈癌患者预后的关系

目的:探讨中性粒细胞减少至最低值时间与局部晚期宫颈癌患者预后的关系。方法:回顾性分析2012年01月至2017年12月我院收治的189例Ⅱb-Ⅳa期宫颈癌患者的临床资料。用ROC工作特征曲线寻找中性粒细胞减少至最低值时间的最佳截断值，根据此截断值将患者分为早期组（88例）和晚期组（101例）。将中性粒细胞减少至最低值时间与患者的临床病理特征进行比较，单因素及Cox回归多因素分析宫颈癌预后的因素。结果:中性粒细胞减少至最低值时间的最佳截断值为32 d。早期组中位生存时间为49个月，晚期组中位生存时间为36个月。中性粒细胞减少至最低值时间在淋巴结转移、临床分期、NLR、PLR的差异有统计学意义（P均＜0.05）。单因素及多因素Cox回归分析显示:淋巴结转移、临床分期、中性粒细胞减少至最低值时间、NLR是影响无进展生存期的独立因素（P＜0.05）。临床分期、中性粒细胞减少至最低值时间也是影响总生存期的独立因素（P＜0.05）。 结论:中性粒细胞减少至最低值时间是影响局部晚期宫颈癌患者预后的独立因素，中性粒细胞减少至最低值时间早的患者预后优于晚的患者。

Association between the time of neutrophils to the lowest and prognosis of patients with locally advanced cervical cancer

Objective:To explore the association between the time of neutrophils to the lowest and prognosis of patients with locally advanced cervical cancer.Methods:The clinical data of 189 patients with cervical cancer in stage IIb-IVa from January 2012 to December 2017 in our hospital were retrospectively analyzed.The ROC working characteristic curve was used to find the best cutoff value for the time of neutrophils to the lowest，and patients were divided into early group(88 cases) and late group(101 cases) according to this cutoff value.The time of neutrophils to the lowest was compared with the clinicopathological characteristics of the patients.Univariate and multivariate Cox regression analysis were used to analyze the prognostic factors of cervical cancer.Results:The best cutoff value for the time of neutrophils to the lowest was 32 d.The median survival time in the early group was 49 months，and the median survival time in the late group was 36 months.There were significant differences in lymph node metastasis，clinical stage，NLR and PLR of the time of neutrophils to the lowest(all P<0.05).Univariate and multivariate Cox regression analysis showed that lymph node metastasis，clinical stage，the time of neutrophils to the lowest and NLR were independent factors affecting progression-free survival(P<0.05).Clinical stage and the time of neutrophils to the lowest were also independent factors affecting the overall survival(P<0.05).Conclusion:The time of neutrophils to the lowest is an independent factor that affects the prognosis of patients with locally advanced cervical cancer.