Pre-treatment neutrophil to lymphocyte ratio is elevated in epithelial ovarian cancer and predicts survival after treatment
Pre-treatment neutrophil to lymphocyte ratio is elevated in epithelial ovarian cancer and predicts survival after treatment
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DOI：
10.1007/s00262-008-0516-3
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发表时间：
2009-01-01
影响因子：
5.8
通讯作者：
Lee, Kook
中科院分区：
文献类型：
--
作者：
Cho, HanByoul;Hur, Hye Won;Lee, Kook
目的炎症细胞既可以抑制也可以刺激肿瘤生长，炎症细胞对临床结果的影响一直是许多研究的焦点。本研究的目的是评估中性粒细胞与淋巴细胞比率 (NLR)（全身炎症反应的测量指标）作为上皮性卵巢癌的附加鉴别生物标志物的有效性，并确定其是否预测生存和复发。方法我们研究了 192 名上皮性卵巢癌患者，其中 173 名良性卵巢肿瘤患者，229 名良性卵巢肿瘤患者。 妇科疾病和405名健康对照。所有研究对象在治疗前均记录血清 CA125 水平和白细胞计数（根据亚型）。在上皮性卵巢癌中，评估了 NLR 与 CA125 结合的诊断有效性。使用单变量和多变量分析，调整已知的预后因素（年龄、分期、细胞类型和分级），分析 NLR 与总生存率和无病生存率之间的相关性。结果 卵巢癌受试者的术前 NLR（平均 6.02）显着高于良性卵巢肿瘤受试者（平均 2.57）、良性妇科疾病受试者（平均 2.55）和健康对照（平均值 1.98）（P < 0.001）。 NLR检测卵巢癌的敏感性和特异性分别为66.1%（95% CI，59.52-72.68%）和82.7%（95% CI，79.02-86.38%）（临界值：2.60）。在早期卵巢癌中，49 名患者中有 19 名 CA125 未升高。这 19 名患者中有 7 名（36.8%）NLR 阳性。在 Cox 多变量分析中，NLR 阳性、III/IV 期和年龄较大是独立的不良预后因素，而 NLR 阳性是最有力的预测变量（风险比 = 8.42 [95% CI: 1.09-64.84]，P = 0.041）。 结论 我们的研究结果为 NLR 与上皮性卵巢癌之间的关联提供了证据。术前 NLR 与 CA125 相结合，可能是一种简单且经济有效的卵巢癌识别方法，并且 NLR 升高可能预测卵巢癌的不良结果。
Purpose Inflammatory cells can both suppress and stimulate tumor growth, and the influence of inflammatory cells on clinical outcome has been the focus of many studies. The purpose of this study was to evaluate the effectiveness of the neutrophil to lymphocyte ratio (NLR), a measure of the systemic inflammatory response, as an additional discriminative biomarker in epithelial ovarian cancer and to determine whether it predicts survival and recurrence.Methods We studied 192 patients with epithelial ovarian cancer, 173 with benign ovarian tumors, 229 with benign gynecologic disease, and 405 healthy controls. Serum CA125 levels and leukocyte counts according to subtypes were recorded prior to treatment in all study subjects. In epithelial ovarian cancer, the diagnostic usefulness of NLR, in combination with CA125, was evaluated. The correlation between NLR and overall and disease-free survival was analyzed using both univariate and multivariate analyses adjusting for the known prognostic factors (age, stage, cell type, and grade).Results Preoperative NLR in ovarian cancer subjects (mean 6.02) was significantly higher than that in benign ovarian tumor subjects (mean 2.57), benign gynecologic disease subjects (mean 2.55), and healthy controls (mean 1.98) (P < 0.001). The sensitivity and specificity of NLR in detecting ovarian cancer was 66.1% (95% CI, 59.52-72.68%) and 82.7% (95% CI, 79.02-86.38%), respectively (cutoff value: 2.60). In early stage ovarian cancer, CA125 was not elevated in 19 out of 49 patients. Seven (36.8%) of these 19 patients were NLR positive. On Cox multivariate analysis, NLR positive, stage III/IV, and older age were independent poor prognostic factors, and being NLR positive was the most powerful predictive variable (Hazard Ratio = 8.42 [95% CI: 1.09-64.84], P = 0.041).Conclusions Our findings provide evidence for the association between NLR and epithelial ovarian cancer. Preoperative NLR, in combination with CA125, may represent a simple and cost-effective method of identifying ovarian cancers, and an elevated NLR may predict an adverse outcome in ovarian cancer.