High platelet-to-lymphocyte ratio predicts improved survival outcome for perioperative NSAID use in patients with rectal cancer
High platelet-to-lymphocyte ratio predicts improved survival outcome for perioperative NSAID use in patients with rectal cancer
复制标题
DOI：
10.1007/s00384-020-03528-8
复制
发表时间：
2020-02-10
影响因子：
2.8
通讯作者：
Yu, Huichuan
中科院分区：
文献类型：
--
作者：
Huang, Zenghong;Wang, Xiaolin;Yu, Huichuan
目的非甾体抗炎药（NSAIDs）已被证明可阻断直肠癌肿瘤相关炎症。然而，非甾体抗炎药的围手术期使用仍存在争议。本研究旨在探讨围手术期使用非甾体抗炎药是否会影响预后，并提供一种预测指标，以确定哪些患者将受益于非甾体抗炎药。方法在这项回顾性研究中，我们招募了515例I至III期直肠癌患者。根据患者围手术期使用非甾体抗炎药的情况，将患者分为非甾体抗炎药组和非甾体抗炎药组。根据血小板与淋巴细胞比率（PLR）对整个队列进行分层。主要终点为无病生存期（DFS）和总生存期（OS）。结果非甾体抗炎药组复发风险比非甾体抗炎药组低12.6% (P = 0.015)，与生存率无显著相关性。在高plr亚组中，与非NSAID组相比，NSAID组的复发风险降低了17.3% (P = 0.003)， DFS结果更好（P = 0.033）。多变量分析证实了这与DFS的独立显著相关性（P = 0.023）。在低plr组中，使用非甾体抗炎药与生存率的相关性不显著。结论围手术期使用非甾体抗炎药可改善高PLR直肠癌患者的生存结局。
Purpose Nonsteroidal anti-inflammatory drugs (NSAIDs) have been shown to block tumor-associated inflammation in rectal cancer. However, the perioperative use of NSAIDs remains controversial. This study was designed to investigate whether the perioperative use of NSAIDs influences outcomes and to provide a predictive marker to identify patients who would benefit from NSAIDs. Methods We enrolled 515 patients with stage I to III rectal cancer in this retrospective study. Patients were classified into the NSAID and non-NSAID groups according to their perioperative use of NSAIDs. The whole cohort was stratified by platelet-to-lymphocyte ratio (PLR). The primary endpoints were disease-free survival (DFS) and overall survival (OS). Results The NSAID group had a 12.6% lower risk of recurrence than the non-NSAID group (P = 0.015), while the association with survival was nonsignificant. In the high-PLR subset, the NSAID group had a 17.3% lower risk of recurrence (P = 0.003) and a better DFS (P = 0.033) outcome than the non-NSAID group. Multivariate analysis confirmed this independent significant association with DFS (P = 0.023). In the low-PLR subset, the association of NSAID use with survival was nonsignificant. Conclusion Perioperative use of NSAIDs was associated with improved survival outcomes in rectal cancer patients with high PLR.