| Xiaoying Quan. The combined prognostic value of pretreatment neutrophil-to-lymphocyte ratio, lymphocyte-tomonocyte ratio, and platelet-to-lymphocyte ratio in stage IE/IIE extranodal natural killer/T-cell lymphoma. Oncol Transl Med, 2019, 5: 137-146. |
| 治疗前中性粒细胞与淋巴细胞比值、淋巴细胞与单核细胞比值、血小板与淋巴细胞比值对在IE/IIE期结外NK/T细胞淋巴瘤的预后价值 |
| The combined prognostic value of pretreatment neutrophil-to-lymphocyte ratio, lymphocyte-tomonocyte ratio, and platelet-to-lymphocyte ratio in stage IE/IIE extranodal natural killer/T-cell lymphoma |
| Received:May 06, 2019 Revised:July 23, 2019 |
| DOI：10.1007/s10330-019-0353-3 |
| 中文关键词: 结外NK/T细胞淋巴瘤；中性粒细胞/淋巴细胞比值；淋巴细胞/单核细胞比值；血小板/淋巴细胞比值；预后 |
| 英文关键词: extranodal natural killer/T-cell; neutrophil-to-lymphocyte ratio; lymphocyte-to-monocyte ratio; platelet-to-lymphocyte ratio; prognosis |
| 基金项目: |
| Author Name | Affiliation | E-mail | | Xiaoying Quan* | Department of Medical Oncology, The Sixth People''''s Hospital of Chengdu | 1193084163@qq.com |
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| 中文摘要: |
| 本研究旨在探讨治疗前中性粒细胞与淋巴细胞比值(NLR)、淋巴细胞与单核细胞比值(LMR)、血小板与淋巴细胞比值(PLR)在初治IE/IIE结外NK/T细胞淋巴瘤中的预后价值。搜集2009年至2017年于四川肿瘤医院收治132例患者。以总生存率为终点，通过ROC获得NLR、LMR和PLR的截断值。NLR的截断值为3.5，高NLR组患者的PFS (P0.001)和OS (P0.001)较低NLR组患者的生存期短。LMR的截断值为3.0，高LMR组的PFS (P=0.001)和OS (P0.001)较低LMR组患者的生存期长。同样，PLR的截断值为191.7，高PLR组的PFS (P0.001)和OS (P0.001)较低PLR组的生存期差。更进一步，以NLR、LMR和PLR为基础建立新模型，将患者分为低危、中危、中高危和高危组，四组间的PFS (P<0.001)和OS (P<0.001)也存在统计学意义。单因素分析显示，B症状、IIE期、局部肿瘤浸润、ECOG(≥2)、LDH升高、高NLR、低LMR、高PLR的预后差且存在统计学意义。多因素分析显示，PLR是影响PFS[HR=2.073, 95%CI=1.080-3.981, P=0.028]和OS[HR=2.127, 95%CI=1.102-4.107, P=0.025]的独立预后因素。因此，治疗前高PLR是IE/IIE期ENKTL患者生存期差的一种简单预后标记。结合NLR、LMR和PLR可以提供额外分层分析。 |
| 英文摘要: |
| Objective This study aimed to explore the combined prognostic value of pretreatment neutrophil-tolymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), and platelet-to-lymphocyte ratio (PLR) in
newly diagnosed IE/IIE extranodal natural killer/T-cell lymphoma (ENKTL) treated with a P-Gemox regimen
combined with radiotherapy or radiotherapy alone.
Methods A total of 132 patients from 2009 to 2017 at the Sichuan Cancer Hospital were enrolled in
the study. The cutoff values of NLR, LMR, and PLR using overall survival (OS) rate as an endpoint were
obtained by the receiver operating curve.
Results The cutoff value of NLR was 3.5. Patients with high NLR had significantly shorter progressionfree survival (PFS) (P < 0.001) and OS (P < 0.001) than those with low NLR. Similarly, the cutoff value of
LMR was 3.0. The high LMR group had significantly longer PFS (P=0.001) and OS (P < 0.001) than the low
LMR group. Similarly, the cutoff value of PLR was 191.7. The high PLR group was significantly associated
with poor PFS (P < 0.001) and OS (P < 0.001) than the low PLR group. Furthermore, combining NLR, LMR,
and PLR to build a new model to stratify patients into low-, intermediate-, intermediate-high-, and high-risk
groups, there were also significant differences in PFS (P < 0.001) and OS (P < 0.001). The univariate
analysis showed that presenting B symptoms, stage IIE, local tumor invasion, Eastern Cooperative
Oncology Group score ≥ 2, elevated lactate dehydrogenase level, elevated NLR, decreased LMR, and
elevated PLR were significantly associated with poor survival. The multivariate analysis demonstrated that
PLR was an independent prognostic factor for both PFS (hazard ratio [HR] = 2.073, 95% confidence interval
[CI] = 1.080–3.981, P = 0.028) and OS (HR = 2.127, 95% CI = 1.102–4.107, P = 0.025).
Conclusion Elevated pretreatment PLR was a novel simple predictor of poor survival in patients with
stage IE/IIE ENKTL. Combining NLR, LMR, and PLR could provide additional stratification. |
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