Predictive value of neutrophil-lymphocyte ratio and platelet-lymphocyte ratio in non-small cell lung cancer patients treated with immune checkpoint inhibitors: A meta-analysis

BackgroundHigh neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) are associated with poor prognosis in cancer patients treated with Immune checkpoint inhibitors (ICIs). However, whether this relationship exists in non-small cell lung cancer (NSCLC) patients remains unclear. Thus, this meta-analysis was conducted to investigate the prognostic role of NLR and PLR in NSCLC treated with ICIs.MethodsEligible studies that evaluated the value of pre-treatment or post-treatment NLR/PLR in NSCLC patients received ICIs were obtained by searching PubMed, Web of Science, Cochrane Library, and EMBASE. The pooled hazard ratio (HR) and 95% confidence interval (CI) were used to assess the relationship between NLR/PLR and overall survival (OS) and progression-free survival (PFS). Subgroup analysis and publication bias were conducted to investigate heterogeneity.Results1845 NSCLC patients from 21 studies were included and three ICIs(nivolumab, pembrolizumab, and atezolizumab) were used. Overall, high NLR was associated with poor OS (HR: 2.50, 95% CI:1.79–3.51, P < 0.001) and PFS (HR: 1.77, 95% CI:1.51–2.01, P < 0.001). Subgroup analyses were consistent with the pooled results. Similarly, the pooled results for PLR showed that elevated PLR was related to inferior OS (HR: 1.93, 95% CI: 1.51–2.01, P < 0.001) and PFS (HR: 1.57, 95%CI: 1.30–1.90, P < 0.001). However, the subgroup analysis based on test time indicated that there was no significant correlation between post-treatment PLR and survival outcomes.ConclusionNLR and pre-treatment PLR could serve as prognostic biomarkers in NSCLC patients treated with ICIs. However, the value of post-treatment PLR needs further to be evaluated.     

Neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) were associated with disease activity in patients with systemic lupus erythematosus

ObjectiveNeutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) have recently been investigated as two new inflammatory markers used in the assessment of systemic inflammation in many diseases. The purpose of the study was to investigate their relation with disease activity in newly diagnosed SLE patients.MethodsThe study population consisted of 116 SLE patients who did not receive any treatment and 136 healthy controls. We divided the patients into two groups according to the SLE Disease Activity Index 2000 (SLEDAI-2K) system. Group 1 included patients with a score of 9 and lower (patients with mild disease activity), and Group 2 included patients with a score of > 9 (patients with severe disease activity). Correlations between NLR, PLR and disease activity were analyzed.ResultsThe NLR and PLR of SLE patients were significantly higher compared to those of the controls (both P < 0.001). There was a statistically significant difference in NLR and PLR between Group 1 and Group 2 (both P < 0.05). SLEDAI scores positively correlated with NLR (r = 0.312, P < 0.001) and PLR (r = 0.298, P < 0.001). Furthermore, SLE patients with nephritis had higher NLR levels than those without nephritis (P = 0.027). Based on the ROC curve, the best NLR cut-off value to predict SLE patients with severe disease activity was 2.26, with 75% sensitivity and 50% specificity, whereas the best PLR cut-off value was 203.85, with 42.3% sensitivity and 83.9% specificity.ConclusionNLR and PLR were two useful inflammatory markers for assessment of disease activity in patients with SLE.     

Platelet-to-lymphocyte ratio is associated with cardiovascular disease in continuous ambulatory peritoneal dialysis patients

BackgroundChronic kidney disease (CKD) patients have a high incidence of cardiovascular disease (CVD) events, which is related to the inflammatory status of this population. Platelet–to–lymphocyte ratio (PLR) is a relatively new indicator of inflammation. The aim of this study was to investigate the relationship between PLR and the CVD events in continuous ambulatory peritoneal dialysis (CAPD) patients.MethodsA total of 70 stable CAPD patients were included in this study from February 2014 to March 2017, and complete demographic characteristics and clinical laboratory baseline data were collected at enrollment. The primary endpoint was defined as the experienced of CVD events during the follow-up period. Binary logistic regression was used to assess the association between PLR and CVD events in CAPD patients.ResultsDuring a median follow-up period of 22 months, 28 (40%) CAPD patients experienced CVD events. Patients in the CVD event group had a high level of platelets (P < 0.01), C-reactive protein (P < 0.01), PLR (P < 0.01) and neutrophil-to-lymphocyte ratio (NLR) (P < 0.01). However, lymphocyte counts (P < 0.01) were significantly lower than patients without CVD events. Following adjusted binary regression analysis revealed no relationship between high NLR and CVD events (OR, 1.21; 95% CI, 0.52–2.85; p = 0.44). However, the correlation between high PLR and CVD events was significant (OR, 1.05; 95% CI, 1.02–1.08; p < 0.01). High PLR was confirmed as an independent predictor of CVD events.ConclusionOur results demonstrated that PLR was independently associated with CVD events. High PLR can be used to predict the risk of CVD events in CAPD patients. PLR was easy to obtain and can be considered as a routine test to serve the clinic.     

Neutrophil-to-lymphocyte ratio as an independent inflammatory indicator of poor prognosis in IgA nephropathy

BackgroundIgA nephropathy (IgAN) is a chronic immuno-inflammatory progressive disease. Several systemic inflammatory indicators, mainly the neutrophil-to-lymphocyte ratio (NLR), are regarded as valuable markers for many diseases, such as IgA vasculitis and chronic kidney disease. Here, we investigated multiple peripheral blood indicators in a large IgAN registry with regular follow-up to evaluate their effects on IgAN phenotypes and progression.MethodsTotally, 1151 IgAN patients with regular follow-up, and 251 healthy volunteers were enrolled. Complete blood count test results, including counts of white blood cells (WBC), neutrophils (NE), lymphocyte (LY), and platelets (PLT), were collected from medical records. Then, NLR and PLR were calculated.ResultsIgAN patients presented with increased WBC, NE, NLR and PLR levels and decreased LY levels compared with controls. In univariate survival analysis, WBC, NE and NLR showed significant associations with IgAN progression, and NLR had a higher area under the ROC curves than NE and WBC. When adjusted for well-known risk factors, NLR remained an independent risk factor for poor renal outcome in IgAN patients and performed better than NE. By using NLR 2.40 as cutoff point, IgAN patients were divided into two groups. IgAN patients in the high NLR group presented with lower eGFR, higher proteinuria, higher incidence of hypertension, and more severe pathological lesions, as well as lower event-free renal survival rate.ConclusionsWe found patients with IgAN had elevated NLR levels than healthy controls, and the easily available NLR in clinical practice could serve as an independent risk factor for IgAN progression.     

ALB-dNLR评分对急性冠状动脉综合征患者行介入治疗预后的影响

目的 分析白蛋白-衍生的中性粒细胞与淋巴细胞比值（ALB-dNLR）评分对急性冠状动脉综合征（ACS）患者行经皮冠状动脉介入治疗（PCI）预后的影响。方法 连续入选确诊ACS并行PCI的患者共1 744例，收集患者临床资料。患者出院后通过门诊复诊、电话等方式随访，记录其主要不良心血管事件（MACE）。采用受试者工作特征（ROC）曲线确定各炎性指标预测MACE的最佳界值。分析ALB和dNLR与各炎性指标的相关性。通过Kaplan-Meier曲线和Cox 回归模型分析患者发生MACE的影响因素。结果 共纳入1 539例患者，中位随访时间1 141 d，其中MACE组60例，Non-MACE组1 479例。MACE组中性粒细胞计数、dNLR、中性粒细胞与淋巴细胞比值（NLR）、血小板与淋巴细胞比值（PLR）、单核细胞与淋巴细胞比值（MLR）、系统免疫炎性指数（SII）、肌酸激酶同工酶和肌酐水平均较Non-MACE组升高，而淋巴细胞计数、ALB水平较Non-MACE组下降。ALB、dNLR、ALB-dNLR、NLR、PLR、MLR、SII的ROC曲线下面积分别为0.619、0.600、0.645、0.619、0.576、0.587、0.611（均P<0.05）。dNLR与NLR、PLR、MLR、SII均呈正相关（均P<0.05）。ALB≤40.72 g/L、dNLR≥2.30和ALB-dNLR评分升高均为ACS患者PCI术后发生MACE的独立危险因素（P<0.05）。结论 ALB-dNLR评分是ACS患者PCI术后发生MACE的独立预测因素，有望成为预后评估的新型指标。     

Prognostic value of inflammatory and nutritional indexes among advanced NSCLC patients receiving PD-1 inhibitor therapy

Though immunotherapy has to some extent improved the prognosis of patients with advanced non-small cell lung cancer (NSCLC), only a few patients benefit. Furthermore, immunotherapy efficacy is affected by inflammatory and nutritional status of patients. To investigate whether dynamics of inflammatory and nutritional indexes were associated with prognosis, 223 patients were analysed retrospectively. The inflammatory indexes of interest were neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and systemic immune-inflammation index (SII) while prognostic nutritional index (PNI) and the haemoglobin, albumin, lymphocyte and platelet (HALP) score were considered as nutritional indexes. Patients were divided into high and low groups or into ‘increase’ and ‘decrease’ groups based on pre-treatment cut-off values and index dynamics after 6-week follow-up respectively. High pre-treatment PLR (OR = 2.612) and increase in NLR during follow-up (OR = 2.516) were significantly associated with lower objective response rates. Using multivariable analysis, high pre-treatment PLR (HR, 2.319) and increase in SII (HR, 1.731) predicted shorter progression-free survival, while high pre-treatment NLR (HR, 1.635), increase in NLR (HR, 1.663) and PLR (HR, 1.691) and decrease in PNI (HR, 0.611) predicted worse overall survival. The nomogram's C-index in inside validation was 0.718 (95% CI: 0.670–0.766). Our results indicated both nutritional and inflammatory indexes are associated with survival outcomes. Inflammatory indexes were additionally linked to treatment response. Index dynamics are better predictors than baseline values in predicting survival in advanced NSCLC patients receiving PD-1 inhibitor combined with chemotherapy as first-line.     

The role of cancer-related inflammation for prediction of poor survival in postmenopausal female patients with stage II/III colon cancer

ObjectiveCancer-related inflammation (CRI) is thought to be a successful predictor of prognosis in colon cancers (CC), but opinions on how to use it are highly variable. In this study, the role of CRI cells in survival for CC patients was investigated by considering gender and menopausal status.Methods163 stage II/III CC patients who underwent curative surgery between 1995 and 2015 were included in the study. The relationship between CRI cells was examined using a standard methodology.ResultsHigh neutrophil-lymphocyte ratio (NLR) had a better relationship with prognostic factors, especially in postmenopausal women (gender, p = 0.037, positive surgical margin, p = 0.001; MSI, p < 0.001; Crohn’s-like reaction, p = 0.001, etc). Also, the reproducibility of the study was better in postmenopausal women (intra-observer agreement = 0.72, intra-class correlation = 0.722, correlation of estimates = 0.718). In univariate analysis, 5-year survival was worse in postmenopausal women with high NLR (OS, p = 0.001; RFS, p < 0.001). In multivariate analysis, high NLR was independently a worse biomarker for OS (hazard ratio [HR], 1.29; 95% CI, 1.18–2.12; p = 0.001) and RFS (HR, 1.30; 95% CI, 1.21–2.59; p < 0.001) in postmenopausal women.ConclusionsNLR had an independent poor prognostic significance in postmenopausal female patients, and the use of a standard approach for methodology improved successful results.     

吸烟饮酒对胃癌治疗前血红蛋白、PLR、NLR的影响及护理对策

目的 探讨吸烟饮酒对胃癌治疗前血红蛋白、血小板淋巴细胞比率（platelet to lymphocyte ratio,PLR）、中性粒细胞淋巴细胞比率（neutrophil to lymphocyte ratio,NLR）的影响.方法 纳入202例胃癌病例,单因素Kruskal-Wallis和多元线性回归分析吸烟、饮酒与胃癌治疗前血红蛋白、PLR、NLR的关系.结果 Kruskal-Wallis显示吸烟对胃癌治疗前血红蛋白、PLR、NLR差异有统计学意义（P=0.010,0.009,0026）,饮酒则对胃癌治疗前血红蛋白、PLR、NLR无明显影响（P=0.415,0.090,0.168）.多元线性回归显示吸烟对胃癌治疗前血红蛋白（P=0.001）、PLR（P=0.001）有显著关联,但对胃癌治疗前NLR无显著关联（P=0.246）;饮酒对治疗前血红蛋白（P=0.930）、PLR（P=0.665）、NLR （P=0.817）无显著关联;吸烟（P=0.988）、饮酒（P=0.407）不是影响胃癌分期的独立影响因素.结论 吸烟是影响胃癌治疗前血红蛋白降低、PLR升高的独立危险因素,应加强护理干预,改善患者血红蛋白及全身性炎症反应.     

术前全身免疫炎症指数对非肌层浸润性膀胱癌患者肿瘤复发的预测价值 #br#

目的 探讨术前全身免疫炎症指数（SII）对接受经尿道膀胱肿瘤电切术（TURBT）的非肌层浸润性膀胱癌 （NMIBC）患者肿瘤复发的预测价值。 方法回顾性收集201例NMIBC患者的实验室检查和病理结果等临床资料, 根据术前1周的血常规结果计算中性粒细胞与淋巴细胞比值（NLR）、血小板与淋巴细胞比值（PLR）和SII值。利用受 试者工作特征（ROC）曲线分析比较3种指标预测NMIBC患者肿瘤复发的准确性。根据SII的最佳分界值,将患者分 成高SII组和低SII组,比较2组患者临床特征的差异。术后对患者进行随访,采用Kaplan-Meier法检验绘制高SII和 低SII组患者的复发曲线。使用多因素Cox回归模型分析影响NMIBC患者术后肿瘤复发的独立危险因素,然后将独 立危险因素纳入并构建预测NMIBC患者1、2、3年无复发率的列线图。通过一致性指数（C指数）和校准曲线来确定 列线图的预测精度和一致性。 结果NLR、PLR、SII预测NMIBC 患者肿瘤复发的曲线下面积（AUC）分别为0.664、 0.656、0.729。SII预测NMIBC患者肿瘤复发的准确性高于NLR和PLR（Z分别为2.398、2.454,均P＜0.05）。SII的最 佳分界值为385,以此将201例患者分为低SII组（SII＜385,130例）和高SII组（SII≥385,71例）。与低SII组相比,高 SII组肿瘤＞3 cm比例、病理T1分期比例和肿瘤复发率更高（均P＜0.05）。所有患者术后中位随访时间62（33~84）个 月,随访期间共45例（22.4%）出现复发。多因素Cox回归分析结果显示高SII （HR=2.829,95%CI：1.416～5.654）,肿瘤 T1 分期（HR=3.091,95%CI：1.660～5.757）、肿瘤＞3 cm（HR=2.339,95%CI：1.152～4.751）、多发肿瘤（HR=2.083, 95%CI：1.033～4.202）是影响患者术后肿瘤复发的独立危险因素（均P＜0.05）。列线图内部验证的C 指数为0.768 （95%CI：0.699～0.837）。校准曲线表明列线图的预测结果与实际的观测结果一致性良好。 结论SII可作为预测 NMIBC患者肿瘤复发的指标,并且预测准确度高于NLR和PLR。根据独立危险因素构建的列线图具有较高的预测 价值。     

Survivin expression and its potential clinical significance in gastrointestinal stromal sarcoma

This study was designed to determine the level of survivin expression and its clinical significance as a prognostic factor in gastrointestinal stromal sarcoma (GIST). Twenty patients (12 males and 8 females) ranging in age from 25 to 72, with a median age of 53 were evaluated. Failure of TKI treatment was higher in the survivin-positive group (p = 0.06). The rate of metastasis was significantly higher in the survivin positive group vs. the negative group (80% vs. 30%, p = 0.18). The median overall survival (OS) time was 114 (range 29–199) months, and the median disease-free survival (DFS) time was 88 (range 40–135) months. The median progression-free survival (PFS) time was 40 (range 24–55) months. Further, a comparison of patients with survivin positive versus negative tumors, revealed no significant difference for OS, DFS, and PFS (p = 0.45, p = 0.19, p = 0.55, respectively), number of mitoses in 50 HPF (p = 0.14), and tumor size (p = 0.94).In conclusion, survivin was highly expressed in GISTs, although we found no correlation between survivin expression and PFS, DFS and OS, survivin may be a predictive marker in GISTs for disease progression. We believe that additional studies are warranted to determine the clinical significance of survivin expression as a prognostic or predictive marker in patients with GIST.     

入院中性粒细胞与淋巴细胞比值对老年髋部骨折患者预后的预测价值

目的 探讨入院中性粒细胞与淋巴细胞比值（NLR）对老年髋部骨折患者预后的预测价值。方法 连续纳 入2014年1月—2019年12月收治的老年髋部骨折患者725例，收集患者的年龄、性别、骨折情况、治疗方式和实验室 检查等临床资料。根据入院血常规结果计算NLR值，利用受试者工作特征（ROC）曲线确定NLR值的最佳截断值，将 患者分为低NLR组和高NLR组。电话随访患者生存情况，Kaplan-Meier法绘制2组患者的生存曲线，Cox比例风险模 型分析影响预后的危险因素。结果 NLR值的最佳截断值为10.08，以此将患者分为低NLR组（NLR≤10.08，520例） 和高NLR组（NLR＞10.08，205例）。中位随访34.64个月（12~89个月），其中30 d内死亡45例（6.21%）；6个月内死亡 105 例（14.48%）；1 年内死亡 149 例（20.55%）。与低 NLR 组相比，高 NLR 组 30 d、6 个月和 1 年病死率更高（均 P＜ 0.05）。多因素Cox回归分析显示，高NLR值、男性、Charlson合并症指数（CCI）≥1、保守治疗、白蛋白水平降低及血肌 酐升高是影响老年髋部骨折患者1年内死亡的独立危险因素（均P＜0.05）。结论 入院NLR值可作为临床预测老年 髋部骨折患者预后的指标。     

Influence of thymidylate synthase gene polymorphisms on the survival of colorectal cancer patients receiving adjuvant 5-fluorouracil

The present study aimed to prospectively investigate the influence of thymidylate synthase (TS) polymorphisms (5'-TSER, 3'-TSUTR) on the disease-free survival (DFS) and overall survival (OS) of patients with colorectal cancer (CRC) who were treated with adjuvant 5-fluorouracil (5-FU) therapy. Patients were followed up for 19+/-14 months (median+/-SD). TS genotypes were determined from the peripheral blood mononuclear cells of 166 patients by polymerase chain reaction-polyacrylamide gel electrophoresis and restriction fragment length polymorphism methods. 5'-TSER 3R homozygotes showed significantly longer DFS (P = 0.048) and OS (P = 0.009). The 5'-TSER and 3'-TSUTR genotype combination groups showed a significant difference for DFS (P = 0.039) and OS (P = 0.029). Significantly better DFS (P = 0.049) and OS (P = 0.043) were observed for 6 bp/6 bp genotypes in 5'-TSER heterozygotes (n = 80). Based on this, and on hazard ratios obtained by Cox regression analysis of the DFS of genotype-combinations, the patients were classified as belonging to prognostic groups A and B. The DFS and OS of these two groups showed a highly significant difference (P = 0.002 and 0.001). In the multivariate Cox regression model, beside tumour location, the prognostic classification (groups A and B) proved to be an independent prognostic factor. Our data suggest that those TS genotypes and their combinations (group A: 3R/3R with any 3'-TSUTR genotype and 2R/3R with 6 bp/6 bp), which have been reported earlier as having high TS expression, predict significantly longer DFS and OS. We found that a combination of germline TS polymorphisms is an independent prognostic marker in selecting CRC patients with worse prognosis, and it may be worthwhile to examine whether these patients would benefit from an alternative therapy.     

289 例Luminal B 型乳腺癌患者预后的相关因素分析

目的探讨Luminal B型乳腺癌患者预后的影响因素。方法收集2015年1月—2016年12月我院收治的289例Luminal B型乳腺癌患者的临床及随访资料,对血小板/淋巴细胞比值(PLR)、红细胞体积分布宽度(RDW)行受试者工作特征(ROC)曲线分析,计数资料采用χ^2检验及Fisher确切概率法,Kaplan-Meier法绘制生存曲线,组间比较采用Log-rank检验,预后分析采用COX多因素回归模型。结果高、低PLR组乳腺癌患者的无病生存率(DFS)分别为82%(77/94)、94.9%(185/195),高、低RDW组乳腺癌患者DFS分别为85.3%(139/163)、97.6%(123/126)。单因素分析显示,生育史、腋窝淋巴结、病理分期、脉管癌栓、PLR、RDW、辅助化疗、内分泌治疗是影响Luminal B型乳腺癌患者预后的危险因素(P<0.05)。COX多因素分析显示,生育史、RDW、辅助化疗、内分泌治疗是影响Luminal B型乳腺癌患者预后的独立危险因素(P<0.05)。结论Luminal B型乳腺癌术前RDW测定具有一定的预测价值,RDW升高可提示预后不良;无生育史或首次生育年龄≥35岁的Luminal B型乳腺癌患者复发风险较高。     

系统免疫炎症指数对新型冠状病毒肺炎核酸转阴时间的影响

目的　探讨系统免疫炎症指数（SII）对新型冠状病毒肺炎（COVID-19）核酸转阴时间的影响。方法　选取接受住院治疗并康复出院的127例COVID-19患者为研究对象,通过电子病历系统收集患者临床资料及入院24 h内的实验室检查结果,根据血常规结果计算SII值并以其中位数将患者分为高SII组（≥393）和低SII组（＜393）,比较2组的临床资料及中性粒细胞与淋巴细胞比值（NLR）、血小板与淋巴细胞比值（PLR）、C反应蛋白（CRP）、白细胞介素（IL）-6、白蛋白（ALB）的差异。Cox回归分析确定影响核酸转阴时间的危险因素。Kaplan-Meier法比较不同组患者的核酸转阴曲线。结果　高SII组的男性比例、NLR、PLR、CRP均高于低SII组（P＜0.05）。Cox多因素回归分析显示,发病至入院时间＞5 d、重症、高SII是影响核酸转阴的独立危险因素（P＜0.05）。Kaplan-Meier曲线显示,高SII值、重症、发病至入院时间＞5 d的患者核酸转阴中位时间分别长于低SII值、非重症、发病至入院时间≤5 d的患者,差异均有统计学意义（P＜0.05）。结论　SII是反映机体炎症及免疫状态的综合指标,简单易得,高SII值为COVID-19患者核酸转阴时间延长的独立危险因素。     

中性粒细胞/淋巴细胞比率与转移性胃癌患者预后的关系

目的　研究中性粒细胞/淋巴细胞比率（NLR）与转移性胃癌患者预后的关系。方法　回顾性分析148例转移性胃癌患者的临床病理资料,根据NLR中位数将患者分为高NLR组（NLR≥2.51,73例）与低NLR组（NLR＜2.51,75例）。比较2组患者的临床病理特点和总生存率,Cox多因素分析确定影响转移性胃癌总生存率的危险因素,Kaplan-Meier法绘制2组患者的生存曲线。结果　高NLR组转移部位≥2、肝脏转移、腹膜转移、幽门螺旋杆菌感染及癌胚抗原（CEA）≥5 μg/L比例明显高于低NLR组（P＜0.05）。生存分析结果显示,高NLR组的生存时间明显短于低NLR组（10个月vs. 22个月,Log-rank χ2=4.125,P＜0.05）。高NLR组患者随访1、3、5年的总生存率明显低于低NLR组患者（26.03% vs. 65.33%、6.85% vs. 16.00%、0 vs. 4.00%,均P＜0.05）。Cox多因素分析结果表明肝脏转移、腹膜转移及NLR≥2.51均是影响转移性胃癌患者总生存率的独立危险因素。结论　NLR可以预测转移性胃癌患者的远期生存情况,NLR≥2.51的患者远期生存较差。     

外周血中性粒细胞-淋巴细胞比值、血小板-淋巴细胞比值在妇科肿瘤中的研究进展

近年来炎症在肿瘤发生发展中的作用研究已日益成为热点,并且取得了很多成果。中性粒细胞-淋巴细胞比值(NLR)、血小板-淋巴细胞比值(PLR)是研究较多的两种生物学指标,在多种肿瘤研究中发现NLR、PLR与肿瘤临床病理特征存在关系,并可评估病人预后。该文现就NLR、PLR在肿瘤中的作用以及在妇科恶性肿瘤中的最新进展进行综述。     

血小板/淋巴细胞比值、中性粒细胞/淋巴细胞比值及危险分层评分对ST段抬高型心肌梗死行经皮冠状动脉介入术后主要心血管不良事件的预测价值

目的 探讨血小板/淋巴细胞比值（PLR）、中性粒细胞/淋巴细胞比值（NLR）及危险分层评分对ST段抬高型心肌梗死（STEMI）病人行直接经皮冠状动脉介入术（PCI）治疗后主要心血管不良事件（MACE）的预测价值。方法 选取2018年1月至2019年12月在南宁市第六人民医院行直接PCI治疗的STEMI病人135例,根据术后30 d内是否发生MACE分为MACE组（n=42）和非MACE组（n=93）。所有病人入院确诊后均行直接PCI治疗,在术后7 d进行血常规检查,根据检测计算PLR、NLR。采用全球急性冠状动脉事件注册（GRACE）危险分层评分对病人进行风险评分。比较MACE组和非MACE组病人PLR、NLR、GRACE评分,并观察不同水平PLR、NLR、GRACE评分的病人术后30 d内MACE的发生率。以受试者操作特征（ROC）曲线下面积（AUC）评估PLR、NLR、GRACE评分及三者联合对STEMI病人术后MACE的预测价值。结果 MACE组病人PLR[(128.4±13.6)分比（112.2±21.6）分]、NLR[(5.74±1.42)分比（5.12±1.13）分]、GR...     

中性粒细胞/淋巴细胞比值对微小病变型肾病发生激素性骨坏死的预测价值

目的　探讨中性粒细胞与淋巴细胞的比值（NLR）预测微小病变型肾病（MCD）患者发生激素性骨坏死的价值。方法　回顾性分析经皮肾穿刺活检术诊断的329例MCD患者的临床资料。根据受检者工作特征（ROC）曲线确定NLR诊断MCD发生激素性骨坏死的最佳截断值,以截断值为界将研究对象分为低NLR组（NLR≤3.321）262例和高NLR组（NLR＞3.321）67例,比较2组患者的基线临床指标、激素用量及时间、合用钙剂及活性维生素D3情况,分析NLR与MCD患者发生激素性骨坏死的相关性,以Kaplan-Meier生存曲线比较2组患者的关节生存率;以多因素Cox回归模型分析MCD患者发生激素性骨坏死的危险因素。结果　全部患者的总中位随访时间为38个月。高NLR组的年龄、白细胞计数、单核细胞计数、C反应蛋白、红细胞沉降率、纤维蛋白原、骨钙素、β胶原特殊序列、血尿素氮、血肌酐及发生激素性骨坏死的比例均较低NLR组高,估算肾小球滤过率较低NLR组降低（P＜0.05）。Kaplan-Meier生存曲线显示,低NLR组患者的关节累积生存率明显高于高NLR组（c2=10.130,P＜0.01）,高NLR组与低NLR组的1年、3年、5年生存率分别为82.9% 和93.5%、76.3%和88.9%、65.2%和85.6%。多因素Cox回归分析结果显示,高NLR水平是MCD患者发生激素性骨坏死的独立危险因素（HR=2.155,95%CI：1.136～4.089,P＜0.05）。结论　血NLR水平与MCD患者发生激素性骨坏死的风险相关,可作为评估MCD患者发生激素性骨坏死风险的有价值指标。     

老年初治非转移鼻咽癌的预后分析

目的探索老年初治非转移鼻咽癌的预后因素。方法选择我院收治的98例年龄≥70岁的鼻咽癌患者为研究对象,主要研究终点为总生存时间(OS)。采用Kaplan-Meier法模拟生存曲线,COX比例风险模型进行多因素分析。结果患者3年和5年OS分别为74.3%和54.3%。多因素分析显示,年龄、KPS评分和ACE-27评分是患者OS的独立预后因素,其中年龄≥75岁(HR=2.315,P=0.009)、KPS评分<80分(HR=2.258,P=0.025)和ACE-27评分2~3分(HR=3.349,P<0.001)为不良预后因素。结论年龄、KPS评分和ACE-27评分为老年鼻咽癌患者的重要预后因素,治疗前需充分评价患者一般状况与合并症情况。     

DCC and TS protein expression in resected gastric cancer: A Hellenic Cooperative Oncology Group Study

There is a high risk of relapse after resection of gastric cancer. We studied the prognostic significance of the deleted colorectal cancer (DCC) gene and thymidylate synthase (TS) protein expression after resection of gastric cancer. Protein expression in the primary tumor of 146 patients with serosal and/or lymph node involvement was studied immunohistochemically by using anti-DCC and anti-TS monoclonal antibodies. DCC expression was found in 69.9%, while low TS staining intensity (0+,1+) and focal staining (<25% of tumor cells stained) were found in 44.6% and 33.8%, respectively. Overall survival (OS) was significantly longer in patients with DCC (p=0.014) negative tumors. TS expression was not an independent prognostic factor. Lack of DCC expression was associated with significantly longer cause-specific survival (CSS) (p=0.040) after curative resection. In conclusion, DCC expression is an independent prognostic factor in patients undergoing resection of gastric cancer while TS expression was not associated with the prognosis in our study.