黄培坚,潘志锋,苏鸿凯.联合CRP/ALB比值和NLR对宫颈鳞状细胞癌预后的评估价值[J].转化医学杂志,2019,8(2):85-88
联合CRP/ALB比值和NLR对宫颈鳞状细胞癌预后的评估价值
Prognostic vale of CRP/ALB ratio and NLR in cervical squamous cell carcinoma
  
DOI:
中文关键词:  宫颈癌  中性粒细胞和淋巴细胞比值  生存率
英文关键词:Cervical cancer  Neutrophils-to-lymphocytes ratio (NLR)  Overall survival
基金项目:
作者单位
黄培坚 南方医科大学附属小榄医院检验科 
潘志锋 南方医科大学附属小榄医院检验科 
苏鸿凯 中山大学肿瘤医院检验科 
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中文摘要:
      目的 探讨术前外周血中性粒细胞/淋巴细胞比值(neutrophils-to-lymphocytes ratio,NLR)、血清C反应蛋白(C reactive protein,CRP)/白蛋白(albumin,ALB)比值等临床常见的炎症指标与宫颈鳞状细胞癌(squamous cell carcinoma,SCC)临床预后的关系。方法 选取2008年9月—2010年12月中山大学肿瘤医院收治的SCC患者168例和2009年1月—2010年12月南方医科大学附属小榄医院收治的SCC患者30例。采集患者的临床资料和随访资料,使用均值作为最佳分界点,并以此将SCC患者分为高值组(NLR>1.60和CRP/ALB>0.022)和低值组(NLR≤1.60和CRP/ALB≤0.022),分析NLR和CRP/ALB比值与SCC患者临床病理特征之间的相关性。采用Kaplan-Meier生存分析、单因素及多因素Cox回归分析,评估术前外周血NLR和CRP/ALB比值对SCC患者术后生存的影响。结果 单因素分析显示肿瘤分期、淋巴结转移、治疗方式、CRP/ALB比值和NLR均为影响SCC患者预后的因素(P<0.05);多因素分析显示血清淋巴结转移(HR=0.41;95%CI:0.22~0.79;95%CI:1.05~4.98;P=0.008)、治疗方式(HR=2.72;95%CI:1.46~5.07;P=0.002)、CRP/ALB比值(HR=2.36;95%CI:1.02~5.47;P=0.045)和NLR(HR=2.28;95%CI:1.05~4.98;P=0.038)是SCC的独立预后指标,低值组和高值组SCC患者的7年生存率分别为97%和68%。结论 术前NLR和CRP/ALB比值是影响SCC患者预后的独立危险因素之一,联合两者可以更好的用于宫颈癌的预后评估分析。
英文摘要:
      Objective This work was aimed to explore the prognostic value of inflammatory prognostic factors in patients with cervical cancer. Methods This study was a retrospective analysis of the data related to patients with newly diagnosed cervical squamous cell carcinoma (SCC). One hundred and sixty-eight untreated patients with SCC in Sun Yat-sen University Cancer Center from September 2008 to December 2010, 30 cases of SCC patients in Xiaolan Hospital Affiliated to Southern Medical University from January 2009 to December 2010. The potential prognostic factors were evaluated by univariate and multivariate survival analysis. Results Univariate analysis showed that stage, lymph node metastasis, treatment, C reactive protein (CRP)/albumin (ALB) ratio and neutrophils-to-lymphocytes ratio (NLR) were prognostic factors for SCC patients (P<0.05); multivariate analysis showed that serum lymph node metastasis (HR=0.41; 95%CI: 0.22—0.79; P=0.008), treatment (HR=2.72; 95%CI: 1.46—5.07; P=0.002), CRP/ALB ratio (HR=2.36; 95%CI: 1.02—5.47; P=0.045) and NLR(HR=2.28; 95%CI: 1.05—4.98; P=0.038) were independent predictors of overall survival (OS) in SCC. The combined index of NLR and CRP/ALB ratio could enhance the prognostic value compared to NLR or CRP/ALB ratio alone. The 7 year survival rates of low and elevated NLR and CRP/ALB ratio groups were 97% and 68% respectively. Conclusion CRP/ALB ratio might be considered as a novel prognosis factor and combined with NLR could improve the accuracy of prediction in patients with cervical cancer.
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