Prognostic performance of inflammation-based prognostic indices in patients with resectable colorectal liver metastases
Prognostic performance of inflammation-based prognostic indices in patients with resectable colorectal liver metastases
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DOI：
10.1007/s12032-015-0590-2
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发表时间：
2015-05-01
期刊：
影响因子：
3.4
通讯作者：
Dennison, Ashley R.
中科院分区：
文献类型：
--
作者：
Neal, Christopher P.;Cairns, Vaux;Dennison, Ashley R.
已经开发了一系列全身炎症反应的预后细胞指标，即嗜中性粒细胞-淋巴细胞比率（NLR）、衍生NLR（dNLR）、血小板-淋巴细胞比率（PLR）、淋巴细胞-单核细胞比率（LMR）、血小板计数和嗜中性粒细胞-淋巴细胞比率的组合（COP-NLR）和预后营养指数（PNI），并发现其在各种恶性肿瘤中具有预后效用。目前的研究是第一次检查这六个炎症评分在可切除的结直肠肝转移（CRLM）患者中的预后价值。对302例连续接受手术治疗可切除CRLM的患者的数据进行了评价。采用log-rank分析、单因素和多因素考克斯回归分析，分析临床病理变量和炎症评分NLR、dNLR、PLR、LMR、COP-NLR和PNI对总生存期（OS）和癌症特异性生存期（CSS）的预后影响。术前高NLR是唯一与膀胱切除术后OS缩短（HR 1.769，95% CI 1.302-2.403，P < 0.001）或CSS缩短（HR 1.927，95% CI 1.398-2.655，P < 0.001）独立相关的炎症变量。当分析中用dNLR取代NLR时，高dNLR与OS缩短（HR 1.932，95% CI 1.356-2.754，P < 0.001）和CSS缩短（HR 1.807，95% CI 1.209-2.702，P = 0.004）独立相关。炎症评分PLR、LMR、COP-NLR和PNI与研究人群的总体或癌症特异性生存期无独立相关性。我们的研究结果支持术前高NLR和dNLR作为CRLM切除术患者预后不良的独立预后因素，其预后价值上级于其他基于细胞的全身炎症评分。
A range of prognostic cellular indices of the systemic inflammatory response, namely the neutrophil-lymphocyte ratio (NLR), derived NLR (dNLR), platelet-lymphocyte ratio (PLR), lymphocyte-monocyte ratio (LMR), combination of platelet count and neutrophil-lymphocyte ratio (COP-NLR) and prognostic nutritional index (PNI), have been developed and found to have prognostic utility across varied malignancies. The current study is the first to examine the prognostic value of these six inflammatory scores in patients with resectable colorectal liver metastases (CRLM). Data from 302 consecutive patients undergoing surgery for resectable CRLM were evaluated. The prognostic influence of clinicopathological variables and the inflammatory scores NLR, dNLR, PLR, LMR, COP-NLR and PNI upon overall survival (OS) and cancer-specific survival (CSS) were determined by log-rank analysis and univariate and multivariate Cox regression analyses. High preoperative NLR was the only inflammatory variable independently associated with shortened OS (HR 1.769, 95 % CI 1.302-2.403, P < 0.001) or CSS (HR 1.927, 95 % CI 1.398-2.655, P < 0.001) following metastasectomy. When NLR was replaced by dNLR in analyses, high dNLR was independently associated with shortened OS (HR 1.932, 95 % CI 1.356-2.754, P < 0.001) and CSS (HR1.807, 95 % CI 1.209-2.702, P = 0.004). The inflammatory scores PLR, LMR, COP-NLR and PNI demonstrated no independent association with either overall or cancer-specific survival in the study population. Our findings support high preoperative NLR and dNLR as independent prognostic factors for poor outcome in patients undergoing CRLM resection, with prognostic value superior to other cellular-based systemic inflammatory scores.