外周血中性粒细胞/淋巴细胞比值和血小板/淋巴细胞比值预测前列腺癌去势治疗后的病情进展
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R737.25

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海南省卫生计生行业科研项目(19A300105)


Neutrophil⁃to⁃lymphocyte ratio and platelet⁃to⁃lymphocyte ratio of peripheral blood predict progressiveness after androgen deprivation therapy in prostate cancer
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    摘要:

    目的:探讨前列腺癌(prostate cancer,PC)患者中性粒细胞/淋巴细胞比值(neutrophil-to-lymphocyte ratio,NLR)、血小板/淋巴细胞比值(platelet-to-lymphocyte radio,PLR)与雄激素剥夺疗法后病情进展的关联。方法:纳入2017年5月—2020年5月收治于三亚中心医院(海南省第三人民医院)的170例PC患者作研究对象,所有患者接受雄激素剥夺疗法并随访1年。将随访期间进展成去势抵抗性前列腺癌(castration-resistant prostate cancer,CRPC)者纳入进展组,其余纳入稳定组。比较两组一般资料、NLR、PLR、单核细胞/淋巴细胞比值(monocyte-to-lymphocyte ratio,MLR)等检查结果,应用多因素Logistic回归分析接受雄激素剥夺治疗的患者进展至CRPC的相关因素,绘制受试者工作特征(receiver operating characteristic,ROC)曲线评估NLR和PLR 对患者1年内发生CRPC的预测效能。结果:随访结束时排除14例失访及2例其他原因死亡患者,剩余154例中44例纳入进展组,110例纳入稳定组;两组Gleason评分、T分期、N分期例数分布比较,差异均有统计学意义(P < 0.05);进展组NLR和PLR高于稳定组(P < 0.05),两组前列腺特异性抗原(prostate specific antigen,PSA)水平及其最低值(PSA nadir)例数分布比较差异有统计学意义(P < 0.05);观察到低NLR组患者1年累积死亡率低于高NLR组(log-rank χ2 =5.094,P=0.024);低PLR组患者1年累积死亡率低于高PLR组(log-rank χ2 =9.931,P=0.002);Gleason评分≥8分(OR=3.998,P=0.034)、PLR(OR=1.156,p<0.001)、NLR (OR=13.844,P < 0.001)、T4分期(OR=16.252,P=0.048)为进展至CRPC的独立危险因素;NLR和PLR预测PC患者1年内发生 CRPC的曲线下面积(area under the curve,AUC)分别为0.845和0.865,两者AUC值比较差异无统计学意义(P > 0.05)。结论: 前列腺癌患者基线NLR和PLR值与CRPC发生相关,二者未来可能成为预测CRPC的有效手段。

    Abstract:

    Objective:This study aims to explore the association between neutrophil - to - lymphocyte ratio(NLR),platelet - to - lymphocyte ratio(PLR)and progress after androgen deprivation therapy in patients with prostate cancer(PC). Methods:Total 170 PC patients treated in Sanya Central Hospital(the Third People’s Hospital of Hainan Province)from May 2017 to May 2020 were employed as study subjects. All patients received androgen deprivation therapy and follow -up for 1 year. Patients who progressed to castration - resistant prostate cancer(CRPC)during follow - up were included in the progress group,and the rest were included in the stable group. Examination results such as general data,NLR,PLR and monocyte to lymphocyte ratio(MLR)of two groups were comparatively analyzed,analyzing the factors associated with progressing to CRPC by multivariate logistic regression analysis, constructing receiver operating characteristic(ROC)curve to assess prediction efficiency of NLR and PLR for predicting CRPC within 1 year. Results:At the end of follow-up,14 patients who were lost to follow-up and 2 patients who died of other causes were excluded,44 of the remaining 154 cases were included in the progress group,and 110 cases were included in the stable group. There were statistical differences between two groups in the distribution of the number of Gleason score,T stage and N stage(P < 0.05). NLR and PLR in the progress group were higher than those in the stable group(P < 0.05). There were statistical differences between two groups in the distribution of the number of prostate specific antigen(PSA)level and its nadir(PSA nadir)(P < 0.05). The 1-year mortality was lower in the low NLR group than in the high NLR group(log rank χ2 =5.094,P=0.024);1-year mortality was lower in the low PLR group than in the high PLR group(log rank χ2 =9.931,P=0.002);Gleason score≥8 points(OR=3.998,P=0.034),PLR(OR=1.156,P < 0.001),NLR(OR=13.844,P < 0.001)and T4 stage(OR=16.252,P=0.048)were the risk factors of progressing to CRPC. AUC of NLR and PLR for predicting CRPC within 1 year were 0.845 and 0.865. There was no statistically significant difference between the area under the curve(AUC)of both(P > 0.05). Conclusion:Baseline NLR and PLR in patients with PC correlate with the occurrence of CRPC,and both may be effective measures to predict CRPC in the future.

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罗后宙,陈国强.外周血中性粒细胞/淋巴细胞比值和血小板/淋巴细胞比值预测前列腺癌去势治疗后的病情进展[J].南京医科大学学报(自然科学版),2022,42(9):1265-1270

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  • 在线发布日期: 2022-09-14
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