Combined Plasma Fibrinogen and Neutrophil Lymphocyte Ratio in Ovarian Cancer Prognosis May Play a Role?
Combined Plasma Fibrinogen and Neutrophil Lymphocyte Ratio in Ovarian Cancer Prognosis May Play a Role?
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DOI：
10.1097/igc.0000000000001233
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发表时间：
2018-06-01
影响因子：
4.8
通讯作者：
Panici, Pierluigi Benedetti
中科院分区：
文献类型：
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作者：
Marchetti, Claudia;Romito, Alessia;Panici, Pierluigi Benedetti
目的在卵巢癌(OC)中，约70%的患者会在确诊后12个月内复发；炎症在肿瘤的发生发展中起着重要作用，因此，中性粒细胞/淋巴细胞比率(NLR)和纤维蛋白原(F-NLR)的联合检测已被认为是几种肿瘤的预后标志物。本研究的目的是探讨神经生长因子受体、纤维蛋白原和F-神经生长因子受体与卵巢癌患者生存的关系。收集治疗前全血细胞计数数据。中性粒细胞/淋巴细胞比率定义为中性粒细胞绝对数除以淋巴细胞绝对数；F-NLR评分低NLR和纤维蛋白原为0，低NLR和高纤维蛋白原为1，或相反，两者均为2。我们将该指标与无进展生存期相关联。结果共纳入94例患者。确诊时的中位年龄为55岁(34-83岁)；超过80%的患者确诊时表现为国际妇产科联合会III-IV期，72例(77%)患者表现为高级别浆液性组织学。57名女性(60%)接受了初次去髓核手术，37名(40%)接受了间歇性去髓核手术。平均血清NLR为5.25±5.37，平均Fg/L为4.19+/-0.97g/L，平均随访时间为27个月(8~60个月)。F-NLR值为2的患者均为晚期，高于F-NLR值为0的患者的%(P<；0.031)；这些患者更多地需要新辅助化疗(P<；0.003)，并且更容易出现铂耐药疾病(P<；0.022)。F-NLR值高的患者无进展生存期(12个月)明显低于F-NLR值低的患者(42月，P=0.023)。结论联合应用NLR值和纤维蛋白原水平可以预测OC患者的预后和治疗反应。
Objectives In ovarian cancer (OC), approximately 70% will relapse within 12 months from diagnosis; inflammation plays an important role in cancer initiating and progression; thus, a combination of neutrophil-to-lymphocyte ratio (NLR) and fibrinogen (F-NLR) has been proposed as prognostic marker in several tumors. The aim of our study was to investigate the correlation between NLR, fibrinogen, and F-NLR and survival in OC population.Methods Patients with diagnosis of OC admitted to our institute between 2011 and 2016 were included. Data about pretreatment complete blood count were collected. Neutrophil-to-lymphocyte ratio was defined as the absolute neutrophil count divided by the absolute lymphocyte count; the F-NLR score was 0 for low NLR and fibrinogen, 1 for low NLR and high fibrinogen, or, conversely, 2 for both high markers. We correlated this index with progression-free survival.Results A total of 94 patients were enrolled. Median age at diagnosis was 55 (34-83) years; more than 80% of patients presented International Federation of Gynecology and Obstetrics stage III-IV at diagnosis, and 72 (77%) presented high-grade serous histology. Primary debulking surgery was performed in 57 women (60%), whereas 37 (40%) underwent interval debulking surgery. Mean serum NLR was 5.25 5.37, and mean serum fibrinogen value was 4.19 +/- 0.97 g/L. The median follow-up time was 27 months (range, 8-60 months). All patients with F-NLR value of 2 presented advanced disease compared with 64% of those with F-NLR of 0 (P < 0.031); these patients more frequently required neoadjuvant chemotherapy (P < 0.003) and more often had platinum-resistant disease (P < 0.022). Patients with high F-NLR presented worse progression-free survival than did patients with low F-NLR (12 vs 42 months, respectively, P = 0.023).Conclusions Combining NLR and fibrinogen levels could be used as a factor for prediction of prognosis and response to treatment in patients affected with OC.