Pretreatment neutrophil-to-lymphocyte ratio and its dynamic change during neoadjuvant chemotherapy as poor prognostic factors in advanced ovarian cancer.
Pretreatment neutrophil-to-lymphocyte ratio and its dynamic change during neoadjuvant chemotherapy as poor prognostic factors in advanced ovarian cancer.
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DOI：
10.5468/ogs.2018.61.2.227
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发表时间：
2018-03
影响因子：
--
通讯作者：
Lee JY
中科院分区：
文献类型：
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作者：
Kim YJ;Lee I;Chung YS;Nam E;Kim S;Kim SW;Kim YT;Lee JY
本研究的目的是确定接受新辅助化疗的晚期上皮性卵巢癌患者的治疗前嗜中性粒细胞与淋巴细胞比率（NLR）及其在化疗期间的动态变化的预后意义。我们对2007年至2015年期间在延世癌症医院接受晚期卵巢癌间隔减瘤手术前接受新辅助化疗的203例患者进行了回顾性分析。在开始新辅助化疗前评价治疗前NLR。NLR的变化定义为新辅助治疗后NLR值除以初始值。分析NLR及其动态变化与化疗反应评分、有效率及复发的相关性。NLR范围为0.64 - 22.8。在单变量分析中，较高的治疗前NLR（>3.81）与较差的总生存期（OS）相关，但与无进展生存期（PFS）无关。通过多变量分析，高治疗前NLR被证明是影响OS的独立参数，但不一定是PFS。化疗期间NLR的变化是比基线NLR更好的PFS预测因子。化疗期间NLR增加的患者显示PFS显著较差，这种变化是PFS的独立预测因素。治疗前NLR及其在化疗过程中的动态变化可能是影响新辅助化疗患者预后的重要因素。
The purpose of this study was to determine the prognostic implications of the pretreatment neutrophil-to-lymphocyte ratio (NLR) and its dynamic change during chemotherapy in patients with advanced epithelial ovarian cancer undergoing neoadjuvant chemotherapy. We performed a retrospective analysis of 203 patients who underwent neoadjuvant chemotherapy prior to interval debulking surgery for advanced-stage ovarian cancer at Yonsei Cancer Hospital between 2007 and 2015. Pretreatment NLR was evaluated before starting neoadjuvant chemotherapy. Change in NLR was defined as the post-neoadjuvant NLR value divided by the initial value. The correlation of NLR and its dynamic change with chemotherapy response score, response rate, and recurrence was analyzed. The NLR ranged from 0.64 to 22.8. In univariate analyses, a higher pretreatment NLR (>3.81) was associated with poor overall survival (OS), but not progression-free survival (PFS). Through multivariate analysis, high pretreatment NLR was shown to be an independent parameter affecting OS, but not necessarily PFS. Changes in NLR during chemotherapy were better predictors of PFS than baseline NLR. Patients with increased NLR during chemotherapy showed significantly poor PFS, and this change was an independent predictor of PFS. Pretreatment NLR and its dynamic change during chemotherapy may be important prognostic factors in patients who undergo neoadjuvant chemotherapy.