Neutrophil-Lymphocyte Ratio is a Simple and Novel Biomarker for Prediction of Survival after Radioembolization for Metastatic Colorectal Cancer
Neutrophil-Lymphocyte Ratio is a Simple and Novel Biomarker for Prediction of Survival after Radioembolization for Metastatic Colorectal Cancer
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DOI：
10.1245/s10434-014-4050-6
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发表时间：
2015-05-01
影响因子：
3.7
通讯作者：
Tsung, Allan
中科院分区：
文献类型：
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作者：
Tohme, Samer;Sukato, Daniel;Tsung, Allan
先前的研究已经报道，术前中性粒细胞-淋巴细胞比率（NLR）升高与包括结直肠癌（CRC）在内的各种实体瘤患者的不良预后相关。在此，我们研究了NLR是否可以预测接受肝放射栓塞治疗的不可切除转移性结直肠癌患者的生存率。回顾性分析了104例在一线和二线化疗失败后接受放射栓塞治疗的不可切除转移性结直肠癌患者。在2002年至2012年期间，所有患者的中位NLR为4.6。使用受试者工作曲线分析，使用NLR截止值4.6或5之间没有差异。48例患者的NLR较高，为千分之一日元5，56例患者的NLR < 5。两组患者既往接受过类似的广泛化疗和肝脏定向干预。高NLR患者的中位生存期为5.6个月（范围4.9-7.9个月），而低NLR患者的中位生存期为10.6个月（范围8.3-17.0个月）;总生存期存在显著差异（对数秩检验; p = 0.001）。与死亡风险相关的其他因素包括疾病的肝外扩散、肺结节的存在、既往肝脏靶向干预和放射学反应。在多变量分析中，高NLR、进行性放射学反应和肝外疾病的存在与死亡风险增加独立相关，NLR是一种简单易行、价格低廉且有用的生物标志物，可预测接受放射栓塞治疗的转移性结直肠癌患者的预后。
Previous studies have reported that an elevated preoperative Neutrophil-Lymphocyte Ratio (NLR) is associated with poor prognosis in patients with various solid tumors including colorectal cancer (CRC). Here, we examine whether NLR predicts survival in patients with unresectable CRC metastases undergoing hepatic radioembolization.A retrospective review of 104 consecutive patients with unresectable metastatic CRC who were treated with radioembolization after failing first and second-line chemotherapy.Between 2002 and 2012, the median NLR for all patients was 4.6. Using receiver operating curve analysis, there was no difference between using an NLR cut-off of 4.6 or 5. Forty-eight patients had a high NLR of a parts per thousand yen5 and 56 patients had an NLR of < 5. Patients in both groups had similar previous extensive chemotherapy and liver-directed interventions. The median survival of patients with high NLR was 5.6 months (range 4.9-7.9 months) compared with 10.6 months (range 8.3-17.0 months) for patients with low NLR; a significant difference was found in overall survival (log-rank test; p = 0.001). Other factors associated with risk of death were extrahepatic spread of disease, presence of pulmonary nodules, previous liver-targeted intervention, and radiographic response. On multivariate analysis, high NLR, progressive radiographic response, and presence of extrahepatic disease remained independently associated with increased risk of death.NLR is a simply attainable, inexpensive, and useful biomarker to predict outcome in patients with metastatic colorectal cancer receiving radioembolization.