Preoperative pulmonary function correlates with systemic inflammatory response and prognosis in patients with non-small cell lung cancer: results of a single-institution retrospective study
Preoperative pulmonary function correlates with systemic inflammatory response and prognosis in patients with non-small cell lung cancer: results of a single-institution retrospective study
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DOI：
10.18632/oncotarget.14225
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发表时间：
2017-04-18
期刊：
影响因子：
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通讯作者：
Chen, Qing
中科院分区：
文献类型：
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作者：
Gao, Yongyin;Zhang, Hongdian;Chen, Qing
本研究旨在分析非小细胞肺癌（NSCLC）患者术前肺功能与全身炎症反应（SIR）生物标志物（如血小板-淋巴细胞比率（NLR）、血小板-淋巴细胞比率（PLR）和淋巴细胞-单核细胞比率（LMR））的关系。此外，还检查了这些标记物的预后意义。回顾性分析358例非小细胞肺癌根治性肺切除术患者的病历资料。肺功能检查值<预测值的80%用于指示损害。受试者工作特征曲线用于确定SIR生物标志物的阈值。然后进行单因素和多因素生存分析，以确定与总生存期（OS）相关的因素。此外，建立了一个基于独立预后因素的预后模型，将患者分为低，中，高风险组。结果表明，术前用力肺活量（FVC）与NLR、PLR和LMR同时相关（P < 0.05）。多变量分析确定年龄、淋巴结状态、FVC和NLR为OS的独立预后因素。亚组分析显示，FVC的预后价值与年龄、淋巴结状态和NLR无关。低、中、高危组的5年总生存率分别为60.9%、35.9%和15.3%（P < 0.05）。总体而言，术前FVC是NSCLC的独立预后预测因子。术前肺功能、SIR和预后之间存在显著相关性。因此，预后模型可以帮助我们识别NSCLC的风险人群。
This study aimed at analyzing the relationship between preoperative pulmonary function and systemic inflammatory response (SIR) biomarkers, such as neutrophilto-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and lymphocyteto-monocyte ratio (LMR) in patients with non-small cell lung cancer (NSCLC). Furthermore, the prognostic significance of these markers was also examined. The medical records of 358 NSCLC patients, who underwent curative lung resection, were retrospectively analyzed. Pulmonary function test values < 80% of the predicted values were used to indicate impairment. A receiver operating characteristic curve was used to determine the thresholds of the SIR biomarkers. Univariate and multivariate survival analyses were then performed to identify the factors associated with the overall survival (OS). Furthermore, one prognostic model based on independent prognostic factors was established to classify the patients into low-, intermediate-, and highrisk groups. Results demonstrated that, preoperative forced vital capacity (FVC) was simultaneously associated with NLR, PLR, and LMR (P < 0.05). Multivariate analysis identified age, lymph node status, FVC, and NLR as independent prognostic factors for OS. A subgroup analysis showed that the prognostic value of FVC was independent of age, lymph node status, and NLR. The five-year OS rates for low-, intermediate-, and high-risk groups of prognostic model were 60.9%, 35.9%, and 15.3%, respectively (P < 0.05). Overall, preoperative FVC was an independent prognostic predictor of NSCLC. Significant correlations were observed among preoperative pulmonary function, SIR, and prognosis. Thus, the prognostic model may help us identify risk populations with NSCLC.