Neutrophil/lymphocyte ratio and its association with survival after complete resection in non-small cell lung cancer
Neutrophil/lymphocyte ratio and its association with survival after complete resection in non-small cell lung cancer
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DOI：
10.1016/j.jtcvs.2008.05.046
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发表时间：
2009-02-01
影响因子：
6
通讯作者：
Lim, Eric
中科院分区：
文献类型：
--
作者：
Sarraf, Khaled M.;Belcher, Elizabeth;Lim, Eric
目的：术前血液检查中中性粒细胞/淋巴细胞比值升高与结直肠癌切除术后生存率降低有关。我们试图确定与中性粒细胞/淋巴细胞比例增加相关的因素，以及非小细胞肺癌切除术患者的分期调整预后影响。方法：我们对1999年至2005年间接受非小细胞肺癌全切除术的患者进行了回顾性分析。数据的获取是通过病人的医疗记录、手术干预前入院时记录的血液结果，以及通过国家卫生服务数据库搜索和医院记录进行的随访。采用Cox比例风险回归估计中性粒细胞/淋巴细胞比例对分期调整生存率的影响。结果：在研究期间，178例患者接受了肺切除术。177例患者中，多数为男性104例（59%），平均年龄63岁（标准差10岁）。中位随访时间为29个月（四分位数间距为8-56个月），1年和5年的总生存率分别为83%和54%。高分期是唯一发现与中性粒细胞/淋巴细胞比值增加相关的因素（P = 0.019）。总白细胞计数（P = 0.990）、中性粒细胞计数（P = 0.490）、年龄（P = 0.290）和细胞类型（P = 0.490）不是死亡率的显著预测因子。在调整分期后的多变量分析中，增加中性粒细胞/淋巴细胞比率（风险比，1.10；95%可信区间，1.03-1.17;P = 0.004）仍然是一个独立的预后指标。结论：术前中性粒细胞/淋巴细胞比例升高与分期升高相关，但仍是原发性肺癌完全切除后生存的独立预测指标，是对I期疾病患者高危死亡进行分层的潜在生物标志物。
Objective: Increasing neutrophil/lymphocyte ratios on preoperative blood tests have been associated with worse survival after resection of colorectal cancer. We sought to determine factors associated with increasing neutrophil/lymphocyte ratios and the stage-adjusted prognostic effect in patients undergoing resection for non-small cell lung cancer.Methods: We performed a retrospective review of patients undergoing complete resection for non-small cell lung cancer between 1999 and 2005. Data acquisition was through patient medical records, blood results recorded on admission before surgical intervention, and follow-up by National Health Service database searches and hospital records. Cox proportional hazards regression was used to estimate the effect of neutrophil/lymphocyte ratio on stage-adjusted survival.Results: During the study period, 178 patients underwent pulmonary resection. Of 177 patients, the majority were male 104 (59%), with a mean age of 63 years (standard deviation, 10 years). The median follow-up time was 29 months (interquartile range, 8-56 months), and overall survival was 83% and 54% at 1 and 5 years, respectively. Higher stage was the only factor found to be associated with increasing neutrophil/lymphocyte ratios (P = .019). Total white cell count (P = .990) and neutrophil count (P = .490), age (P = .290), and cell type (P = .490) were not significant predictors of mortality. On multivariable analysis after adjusting for stage, increasing neutrophil/ lymphocyte ratios (hazard ratio, 1.10; 95% confidence interval, 1.03-1.17; P = .004) remained an independent prognostic indicator.Conclusions: Increasing preoperative neutrophil/lymphocyte ratios are associated with higher stage but remain an independent predictor of survival after complete resection for primary lung cancer and are a potential biomarker to stratify high risk of death in patients with stage I disease.