Neutrophil-to-lymphocyte ratio for predicting palliative chemotherapy outcomes in advanced pancreatic cancer patients.
Neutrophil-to-lymphocyte ratio for predicting palliative chemotherapy outcomes in advanced pancreatic cancer patients.
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DOI：
10.1002/cam4.204
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发表时间：
2014-04
期刊：
影响因子：
4
通讯作者：
Chiba, Tsutomu
中科院分区：
文献类型：
--
作者：
Xue, Peng;Kanai, Masashi;Mori, Yukiko;Nishimura, Takafumi;Uza, Norimitsu;Kodama, Yuzo;Kawaguchi, Yoshiya;Takaori, Kyoichi;Matsumoto, Shigemi;Uemoto, Shinji;Chiba, Tsutomu
一些先前的研究报告，嗜中性粒细胞与淋巴细胞的比例（NLR）可能是一个有希望的预后因素与癌症患者。我们的目的是确定NLR在晚期胰腺癌（APC）患者姑息化疗后的预后价值。我们回顾性分析了2006年1月至2012年12月期间接受姑息化疗的252例连续APC患者。我们根据治疗前NLR值（≤5或>5）将患者分为两组，并研究治疗结果的差异，包括治疗失败时间（TTF）和总生存期（OS）。共有212例患者的治疗前NLR值≤5（A组），而40例患者的NLR>5（B组）。B组的TTF和OS明显短于A组（分别为3.1 vs. 8.7个月和6.0 vs. 12.8个月;均P < 0.01）。采用考克斯回归模型校正了包括远处转移、复发/不可切除疾病状态、治疗前碳水化合物抗原19-9水平和癌胚抗原水平在内的假定预后因素后，治疗前NLR升高仍然是OS的独立不良预后因素（风险比，1.92; 95%置信区间，1.27-2.90; P < 0.01）。此外，B组中在第二周期化疗前NLR降至≤5的患者与NLR保持在>5的患者相比，TTF和OS较长。我们的研究结果支持这样的观点，即NLR可以作为接受姑息化疗的APC患者的一个有前途的预后和预测标志物。
Several previous studies reported that the neutrophil-to-lymphocyte ratio (NLR) could be a promising prognostic factor for patients with cancer. We aimed to determine the prognostic value of NLR in patients with advanced pancreatic cancer (APC) following palliative chemotherapy. We retrospectively reviewed 252 consecutive APC patients receiving palliative chemotherapy between January 2006 and December 2012. We classified the patients according to the pretreatment NLR values (≤5 or >5) into two groups and investigated the difference in treatment outcomes, including time to treatment failure (TTF) and overall survival (OS). A total of 212 patients had pretreatment NLR values of ≤5 (group A), while 40 patients had an NLR of >5 (group B). TTF and OS were significantly shorter in group B than in group A (3.1 vs. 8.7 months and 6.0 vs. 12.8 months, respectively; both P < 0.01). After adjustment for putative prognostic factors, including distant metastasis, status of recurrent/unresectable disease, pretreatment carbohydrate antigen 19-9 levels, and carcinoembryonic antigen levels using the Cox regression model, elevated pretreatment NLR remained an independent poor prognostic factor for OS (hazard ratio, 1.92; 95% confidence interval, 1.27–2.90; P < 0.01). In addition, patients in group B whose NLR dropped to ≤5 before the second cycle of chemotherapy showed longer TTF and OS compared with those whose NLR remained at >5. Our results support the idea that NLR can be a promising prognostic and predictive marker for APC patients receiving palliative chemotherapy.
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