1.Sanya Central Hospital The Third People'2.'3.s Hospital of Hainan Province
目的：探讨晚期前列腺癌患者免疫状态相关指标与雄激素剥夺疗法反应性的关联。方法：纳入2017年5月到2020年5月间收治于我院的170例晚期前列腺癌(prostate cancer,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)的患者纳入反应欠佳组,其余纳入对照组。比较两组一般资料、中性粒细胞/淋巴细胞比值(NLR)、血小板/淋巴细胞比值(PLR)、单核细胞/淋巴细胞比值(MLR)等检查结果,应用多因素COX回归分析法分析患者雄激素剥夺治疗反应性的相关因素,绘制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例纳入反应欠佳组,110例纳入对照组；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)；反应欠佳组NLR和PLR高于对照组(P<0.05),两组前列腺特异性抗原(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)；Gleason评分≥8分(HR=3.998,P=0.034)、PLR(HR=1.156,P=0.000)、NLR(HR=13.844,P=0.000)为治疗反应欠佳的独立危险因素,T2和T3分期(HR=0.062、0.211,P=0.048、0.017)为独立保护因素；NLR和PLR预测PC患者1年内发生CRPC的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：晚期前列腺癌患者基线NLR和PLR值与CRPC发生相关,二者未来或可成为预测雄激素剥夺治疗反应性的有效手段。
Objective To explore the association between immune-related indicators and response to androgen deprivation therapy in patients with advanced prostate cancer.Methods 170 advanced prostate cancer(PC)patients treated in our department 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 poor response group,and the rest were included in the control group.Examination results such as general data,neutrophil to lymphocyte ratio(NLR),platelet-to-lymphocyte ratio(PLR)and monocyte to lymphocyte ratio(MLR)of two groups were comparatively analyzed,Analyzing the factors associated with the response to androgen deprivation therapy by multivariate Cox regression analysis,constructing ROC curve to assess prediction efficiency of NLR and PLR for predicting CRPC within 1 year.Result 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 poor response group,and 110 cases were included in the control group；There were statistical difference 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 poor response group were higher than those in the control group(P<0.05)；There were statistical difference between two groups in the distribution of the number of prostate specific antigen(PSA)level and its nadir(PSA nadir)(P<0.05)；Gleason score≥8 points(HR=3.998,P=0.034),PLR(HR=1.156,P=0.000)and NLR(HR=13.844,P=0.000)were the risk factors of poor response,T2 and T3 stage(HR=0.062、0.211,P=0.048、0.017)were protective factors；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 AUC of both(P>0.05).Conclusion Baseline NLR and PLR in patients with advanced prostate cancer correlate with the occurrence of CRPC,and both may be effective measures to predict response to androgen deprivation therapy in the future.