摘要
目的探讨中性粒细胞与淋巴细胞比值(NLR)、血小板与淋巴细胞比值(PLR)、预后营养指数(PNI)、全身免疫炎症指数(SII)及其联合对肺癌患者术后3年复发/死亡的预测价值。方法回顾性选取2017—2020年于空军军医大学第二附属医院行胸腔镜肺癌根治术且术后3年复发/死亡患者128例作为研究组,术后3年未复发/死亡患者100例作为对照组。收集患者的临床资料,采用单因素和多因素Cox比例风险回归分析探讨肺癌患者术后3年复发/死亡的影响因素。绘制ROC曲线以分析NLR、PLR、PNI、SII及四者联合对肺癌患者术后3年复发/死亡的预测价值。结果多因素Cox比例风险回归分析结果显示,淋巴结转移[HR=1.713,95%CI(1.254~2.286)]、TNM分期Ⅲ期[HR=1.880,95%CI(1.327~2.361)]、NLR升高[HR=1.971,95%CI(1.435~2.595)]、PLR升高[HR=2.246,95%CI(1.626~3.107)]、SII升高[HR=2.107,95%CI(1.534~2.853)]是肺癌患者术后3年复发/死亡的独立危险因素,PNI升高[HR=0.747,95%CI(0.592~0.802)]是其保护因素(P<0.05)。ROC曲线分析结果显示,NLR、PLR、PNI、SII及四者联合预测肺癌患者术后3年复发/死亡的AUC分别为0.739[95%CI(0.673~0.804)]、0.788[95%CI(0.722~0.853)]、0.760[95%CI(0.699~0.821)]、0.819[95%CI(0.760~0.879)]、0.905[95%CI(0.862~0.947)]。四者联合预测肺癌患者术后3年复发/死亡的AUC分别大于NLR、PLR、PNI、SII单独预测的AUC(P值均<0.05)。结论NLR升高、PLR升高、SII升高是肺癌患者术后3年复发/死亡的独立危险因素,PNI升高是其保护因素;NLR、PLR、PNI、SII对肺癌患者术后3年复发/死亡均具有一定预测价值,且四者联合的预测价值更高。
Objective To explore the predictive value of neutrophil to lymphocyte ratio(NLR),platelet to lymphocyte ratio(PLR),prognostic nutritional index(PNI),systemic immune inflammation index(SII)and their combination for recurrence/death within 3 years after surgery in patients with lung cancer.Methods A total of 128 patients who underwent thoracoscope radical resection of lung cancer and recurrence/death within 3 years after surgery in the Second Affiliated Hospital of Air Force Military Medical University from 2017 to 2020 were retrospectively selected as the study group,and 100 lung cancer patients who did not experience recurrence/death within 3 years after surgery were selected as the control group.Clinical data of the patients were collected.Univariate and multivariate Cox proportional hazards regression analysis were used to analyze the influencing factors of recurrence/death within 3 years after surgery in patients with lung cancer.ROC curve was drawn to analyze the predictive value of NLR,PLR,PNI,SII and their combination for recurrence/death within 3 years after surgery in patients with lung cancer.Results Multivariate Cox proportional hazards regression analysis results showed that lymph node metastasis[HR=1.713,95%CI(1.254-2.286)],TNM stageⅢ[HR=1.880,95%CI(1.327-2.361)],elevated NLR[HR=1.971,95%CI(1.435-2.595)],elevated PLR[HR=2.246,95%CI(1.626-3.107)]and elevated SII[HR=2.107,95%CI(1.534-2.853)]were independent risk factors for recurrence/death within 3 years after surgery in patients with lung cancer,while elevated PNI[HR=0.747,95%CI(0.592-0.802)]was its protective factor(P<0.05).ROC curve analysis results indicated that the AUC of NLR,PLR,PNI,SII and their combination for predicting recurrence/death within 3 years after surgery in lung cancer patients was 0.739[95%CI(0.673-0.804)],0.788[95%CI(0.722-0.853)],0.760[95%CI(0.699-0.821)],0.819[95%CI(0.760-0.879)],0.905[95%CI(0.862-0.947)],respectively.And the AUC of the combination of these four indicators in predicting recurrence/death within 3 years after surgery in patients with lung cancer was higher than that of NLR,PLR,PNI,and SII alone in predicting recurrence/death within 3 years after surgery in patients with lung cancer(P values all were<0.05).Conclusion Elevated NLR,elevated PLR,and elevated SII are independent risk factors for recurrence/death within 3 years after surgery in lung cancer patients,while elevated PNI is its protective factor.NLR,PLR,PNI and SII all have certain predictive value for recurrence/death within 3 years after surgery in lung cancer patients,and their combination of these four indicators have a higher predictive value.
作者
房佳琪
邢碧梅
FANG Jiaqi;XING Bimei(Department of Thoracic Surgery,the Second Affiliated Hospital of Air Force Military Medical University,Xi'an 710038,China)
出处
《实用心脑肺血管病杂志》
2025年第8期6-10,共5页
Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease
