Preoperative red cell distribution width and neutrophil-to-lymphocyte ratio predict survival in patients with epithelial ovarian cancer.
Preoperative red cell distribution width and neutrophil-to-lymphocyte ratio predict survival in patients with epithelial ovarian cancer.
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术前红细胞分布宽度和中性粒细胞与淋巴细胞比率可预测上皮性卵巢癌患者的生存率。
DOI：
10.1038/srep43001
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发表时间：
2017-02-22
影响因子：
4.6
通讯作者：
Jiang G
中科院分区：
文献类型：
--
作者：
Li Z;Hong N;Robertson M;Wang C;Jiang G
据报道，术前全血细胞计数(CBC)和由此衍生的炎症相关血细胞标志物的几个参数与上皮性卵巢癌(EOC)患者的预后相关，但它们的预后重要性和最佳界值仍需阐明。对在梅奥诊所接受一次手术的654例上皮性卵巢癌患者的临床/病理参数、5年随访资料和术前血细胞参数进行回顾性分析。根据受试者工作特征(ROC)曲线优化中性粒细胞/淋巴细胞比率(NLR)、血小板/淋巴细胞比率(PLR)和单核细胞/淋巴细胞比率(MLR)的界值。用Cox比例风险模型和Kaplan-Meier法确定总生存期(OS)和无复发生存期(RFS)的预后意义。用非参数检验分析RDW和NLR与临床/病理参数的关系。RDW(RDW)和NLR(NLR)分界值分别为14.5和5.25对OS有独立的预后意义，而RDW和NLR联合评分将患者分为低(RDW-低和NLR-低)、中(RDW-高或NLR-高)和高危(RDW-高和NLR-高)组，尤其是在高级别浆液性卵巢癌(HGSOC)患者中。此外，高NLR也与较差的RFS相关。RDW升高与年龄密切相关，而NLR升高与分期、术前CA125水平和术中腹水密切相关。
Several parameters of preoperative complete blood count (CBC) and inflammation-associated blood cell markers derived from them have been reported to correlate with prognosis in patients with epithelial ovarian cancer (EOC), but their prognostic importance and optimal cutoffs are still needed be elucidated. Clinic/pathological parameters, 5-year follow-up data and preoperative CBC parameters were obtained retrospectively in 654 EOC patients underwent primary surgery at Mayo Clinic. Cutoffs for neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and monocyte-to-lymphocyte ratio (MLR) were optimized by receiver operating characteristic (ROC) curve. Prognostic significance for overall survival (OS) and recurrence free survival (RFS) were determined by Cox proportional hazards models and Kaplan-Meier method. Associations of RDW and NLR with clinic/pathological parameters were analyzed using non-parametric tests. RDW with cutoff 14.5 and NLR with cutoff 5.25 had independent prognostic significance for OS, while combined RDW and NLR scores stratified patients into low (RDW-low and NLR-low), intermediate (RDW-high or NLR-high) and high risk (RDW-high and NLR-high) groups, especially in patients with high-grade serous ovarian cancer (HGSOC). Moreover, high NLR was associated with poor RFS as well. Elevated RDW was strongly associated with age, whereas high NLR was strongly associated with stage, preoperative CA125 level and ascites at surgery.