周文毓, 陈金婵, 惠宁. 治疗前血小板和淋巴细胞比值与宫颈癌新辅助化疗疗效及预后的相关性[J]. 中国肿瘤临床, 2014, 41(16): 1045-1048. DOI: 10.3969/j.issn.1000-8179.20140456
引用本文: 周文毓, 陈金婵, 惠宁. 治疗前血小板和淋巴细胞比值与宫颈癌新辅助化疗疗效及预后的相关性[J]. 中国肿瘤临床, 2014, 41(16): 1045-1048. DOI: 10.3969/j.issn.1000-8179.20140456
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ZHOU Wenyu, CHEN Jinchan, HUI Ning. Association of pre-treatment platelet-to-lymphocyte ratios with response to neoadjuvant chemotherapy and clinical outcomes of cervical cancer patients[J]. CHINESE JOURNAL OF CLINICAL ONCOLOGY, 2014, 41(16): 1045-1048. DOI: 10.3969/j.issn.1000-8179.20140456
Citation: ZHOU Wenyu, CHEN Jinchan, HUI Ning. Association of pre-treatment platelet-to-lymphocyte ratios with response to neoadjuvant chemotherapy and clinical outcomes of cervical cancer patients[J]. CHINESE JOURNAL OF CLINICAL ONCOLOGY, 2014, 41(16): 1045-1048. DOI: 10.3969/j.issn.1000-8179.20140456
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治疗前血小板和淋巴细胞比值与宫颈癌新辅助化疗疗效及预后的相关性

Association of pre-treatment platelet-to-lymphocyte ratios with response to neoadjuvant chemotherapy and clinical outcomes of cervical cancer patients

    摘要
  • 摘要: 目的： 评价治疗前外周血血小板和淋巴细胞比值（PLR）与ⅠB2~ⅡB期宫颈癌新辅助化疗疗效及预后的相关性。 方法： 回顾性分析2010年1月至2012年12月第二军医大学附属长海医院妇产科75例新辅助化疗后行根治性手术的ⅠB2~ⅡB期患者的临床病理资料，绘制ROC曲线分析PLR与新辅助化疗疗效的关系，预测新辅助化疗疗效的最佳临界（cutoff）值。建立Lo?gistic回归模型分析影响新辅助治疗疗效的独立相关因素，采用单因素及Cox回归模型分析PLR和其他临床病理因素与3年生存率的关系。 结果： PLR与新辅助化疗的疗效显著相关，预测新辅助化疗疗效的PLR最佳临界值为123.0，敏感性和特异性分别为0.885和0.522。患者PLR>123.0的3年生存率低于PLR≤123.0（59.8% vs. 82.4%），但差异无统计学意义（P=0.116）。单因素分析显示脉管浸润、肿瘤直径>4 cm、淋巴结转移对患者的3年生存率有影响，多因素分析显示仅淋巴结转移是影响患者生存率的独立危险因素（RR=5.375，95%CI为1.351~21.379，P=0.017）。 结论： 治疗前PLR作为一种简单、经济、可重复的全身炎症反应指标，可有效预测新辅助化疗的疗效，但对预后评估无明显临床价值。

     

    Abstract: Objective: To evaluate the predictive value of pretreatment platelet-to-lymphocyte ratios (PLRs) in response to neoadjuvant chemotherapy and prognostic outcome in patients with International Federation of Gynecologists and Obstetricians (FIGO) Stages IB2-IIB cervical cancer. Methods: An investigation was conducted from January 2010 to December 2012 on 75 patients with FIGO Stages IB2–IIB cervical cancer, who underwent neoadjuvant chemotherapy and radical surgery in Changhai Hospital, Shanghai. A receiver operating characteristic (ROC) curve was used to determine the best PLR cut-off value in predicting the response to neoadjuvant chemotherapy. The relationships between the pretreatment variables and the response to neoadjuvant chemotherapy were assessed in univariate and multivariate settings. The overall three-year survival rates were analyzed using the log-rank test and Cox regression model. Results: The response to neoadjuvant chemotherapy was associated with PLR. At the threshold of 123.0, the PLR was 88.5% sensitive and 52.2% specific. Multivariate analysis showed that the low independent PLR predicted the response to neoadjuvant chemotherapy well. Based on the log-rank test, the three-year survival rate was lower in patients with PLR >123.0 than those with PLR < 123.0(59.8% vs. 82.4%), but no statistically significant differences were observed between them (P=0.116). Mono-factorial analysis showed that vascular invasion (a tumor that is >4 cm in diameter) and lymph node metastasis influenced the three-year survival rate. In the Cox regression model, only the lymph node metastasis was identified as an independent risk factor for poor prognosis (RR: 5.375; 95% CI:1.351-21.379; P=0.017). Conclusion: Pretreatment PLR is an easily measured, reproducible, and inexpensive marker of systemic inflammation and thus shows a prognostic and independent predictive value for the response to neoadjuvant chemotherapy in cervical cancer. However, pretreatment PLR is not a clinically significant factor for the assessment of cervical cancer prognosis.

     

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