疗前绝对淋巴细胞计数及其相关参数比对局部晚期宫颈癌患者疗效的预测价值

目的 探讨治疗前绝对淋巴细胞计数(ALC)及其中性粒-淋巴细胞比(NLR)、单核细胞-淋巴细胞比(MLR)以及血小板-淋巴细胞比(PLR)对局部晚期宫颈癌(LACC)患者预后的预测价值。方法 纳入2016-2019年间新疆医科大学附属肿瘤医院收治的初诊LACC患者175例,完整记录患者的临床资料及治疗前ALC并计算NLR、MLR、PLR。采用Cox模型分析LACC患者的预后预测指标。结果 NLR降低组(<3.34)、MLR降低组(<0.315)LACC患者的无进展生存(PFS)均高于二者升高组(均P<0.05);ALC升高组(≥1.375×10⁹/L)、PLR降低组(<160.575)LACC患者的总生存(OS)均高于ALC降低组和PLR升高组(均P<0.05)。单因素分析显示高危CTV(HR-CTV)的等效剂量EQD2Gy是影响LACC患者PFS的重要预后因素(P=0.03),多因素分析显示FIGO分期(HR=2.339,95%CI为1.22~4.48,P=0.010)、同步放化疗(HR=0.213,95%CI为0.11~0.43,P<0.001)是LACC患者PFS的独立预测因素;而同步放化疗(HR=0.229,95%CI为0.07~0.81,P=0.023)和MLR(HR=4.933,95%CI为1.39~17.54,P=0.014)是LACC患者OS的独立预测因素。结论 局部晚期宫颈癌患者能在同步放化疗中获益,HR-CTV EQD2Gy剂量是影响LACC患者PFS的重要预后因素,治疗前MLR升高是影响LACC患者OS的独立预后因素。

Predictive value of absolute lymphocyte count and its related parameters before treatment in patients with locally advanced cervical cancer

Objective To investigate the prognostic value of absolute lymphocyte count (ALC) and neutrophil-lymphocyte ratio (NLR),macrophage-lymphocyte ratio (MLR) and platelet-lymphocyte ratio (PLR) before treatment in patients with locally advanced cervical cancer (LACC). Methods A total of 175 patients newly-diagnosed with LACC admitted to Cancer Hospital affiliated to Xinjiang Medical University from August 2016 to October 2019 were enrolled in this study. Complete clinical data and ALC before treatment were recorded and NLR, MLR and PLR were calculated. Multivariate Cox′s proportional hazard regression model was used to analyze the prognostic factors of patients with LACC. Results The progress-free survival (PFS) of LACC patients in the NLR reduction group (<3.34) and MLR reduction group (<0.315) were significantly higher than those in the NLR and MLR elevation groups (both P<0.05). The overall survival (OS) of LACC patients in the ALC elevation group (≥1.375 × 10⁹/L) and the PLR reduction group (<160.575) were significantly higher compared with those in the ALC reduction group and PLR elevation group (both P<0.05). Univariate analysis showed that EQD2Gy, the equivalent dose of HR-CTV, was an important prognostic factor of PFS in patients with LACC (P=0.030). Multivariate Cox's regression analysis demonstrated that FIGO staging (HR=2.339, 95%CI 1.22-4.48, P=0.010) and concurrent chemoradiotherapy (HR=0.213, 95%CI 0.11-0.43, P<0.001) were the independent predicators of PFS in patients with LACC. However, concurrent chemoradiotherapy (HR=0.229, 95%CI 0.07-0.81, P=0.023) and MLR (HR=4.933, 95%CI 1.39-17.54, P=0.014) before treatment were the independent predictors of OS in patients with LACC. Conclusions Patients with locally advanced cervical cancer can benefit from concurrent chemoradiotherapy. HR-CTV EQD2Gy is a critical prognostic factor of PFS in patients with LACC. The increase of MLR before treatment is an independent prognostic factor of OS in LACC patients.