中性粒细胞/淋巴细胞比值与小细胞肺癌放疗患者预后的关系

目的:分析外周血中性粒细胞/淋巴细胞比值（NLR）与小细胞肺癌（SCLC）放疗患者预后的关系。方法:回顾性分析2014年1月至2018年12月的91例SCLC患者临床资料，通过受试者工作特征（ROC）曲线获得最佳截断值，将患者分为低NLR组和高NLR组，χ2检验或Fisher's精确概率法检验评估NLR与临床特征的关系，利用Kaplan-Meier法绘制生存曲线，Log-rank法进行单因素预后分析，Cox比例风险回归模型多因素分析NLR值是否为总生存期（OS）和无进展生存期（PFS）的独立预后因素。结果:全组患者1、3年OS率分别为72.5%、39.1%，1、3年PFS率分别为42.9%、19.8%。放疗中和放疗后NLR值对患者预后有诊断价值。放疗中低NLR组的疾病控制率（DCR）显著高于高NLR组（P=0.042）。放疗中和放疗后高NLR组均与较差的OS（P=0.001，0.003）相关，放疗中高NLR组与较差的PFS（P=0.034）相关。放疗中和放疗后NLR是OS的独立预后因素，放疗中NLR是PFS的独立预后因素。结论:放疗中和放疗后NLR是小细胞肺癌患者的预后影响因素，放疗中NLR≥4.425，放疗后NLR≥4.155提示预后不良。

The relationship between neutrophil/lymphocyte ratio and prognosis of small cell lung cancer patients with radiotherapy

Objective:To analyze the relationship between the peripheral blood neutrophil/lymphocyte ratio (NLR) and the prognosis of small cell lung cancer patients with radiotherapy.Methods:The clinical data of 91 SCLC patients from January 2014 to December 2018 were retrospectively analyzed.The receiver operating characteristic (ROC) curve was used to obtain the best cut-off value.The patients were divided into low NLR group and high NLR group,χ2 test or Fisher's exact probability test to evaluate the relationship between NLR and clinical characteristics,Kaplan-Meier method was used to draw survival curve,Log-rank method was used for univariate prognostic analysis,and Cox proportional hazard regression model was used to analyze whether the NLR value was overall survival (OS) and independent prognostic factors of progression-free survival (PFS).Results:The 1-and 3-year OS rates of the whole group were 72.5% and 39.1%,respectively,and the 1-and 3-year PFS rates were 42.9% and 19.8%,respectively.The NLR value during and after radiotherapy had diagnostic value for the prognosis of patients.The disease control rate (DCR) of the low NLR group in radiotherapy was significantly higher than that in the high NLR group (P=0.042).Both the high NLR group during and after radiotherapy were associated with poor OS (P=0.001,0.003),and the high NLR group during radiotherapy was associated with poor PFS (P=0.034).NLR during and after radiotherapy was an independent prognostic factor of OS,and NLR during radiotherapy was an independent prognostic factor of PFS.Conclusion:NLR during and after radiotherapy is a prognostic factor in patients with small cell lung cancer.NLR≥4.425 during radiotherapy and NLR≥4.155 after radiotherapy indicate a poor prognosis.