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NLR、PLR和LMR对脑转移瘤患者全脑放疗预后的影响及相关因素分析

吕凤泉 杜钦文 李海南 蔡林波 邓官华

吕凤泉, 杜钦文, 李海南, 蔡林波, 邓官华. NLR、PLR和LMR对脑转移瘤患者全脑放疗预后的影响及相关因素分析[J]. 分子影像学杂志, 2023, 46(1): 43-47. doi: 10.12122/j.issn.1674-4500.2023.01.08
引用本文: 吕凤泉, 杜钦文, 李海南, 蔡林波, 邓官华. NLR、PLR和LMR对脑转移瘤患者全脑放疗预后的影响及相关因素分析[J]. 分子影像学杂志, 2023, 46(1): 43-47. doi: 10.12122/j.issn.1674-4500.2023.01.08
LÜ Fengquan, DU Qinwen, LI Hainan, CAI Linbo, DENG Guanhua. Effect of pre-radiotherapy NLR, PLR and LMR on the prognosis of patients with brain metastases and analysis of related factors[J]. Journal of Molecular Imaging, 2023, 46(1): 43-47. doi: 10.12122/j.issn.1674-4500.2023.01.08
Citation: LÜ Fengquan, DU Qinwen, LI Hainan, CAI Linbo, DENG Guanhua. Effect of pre-radiotherapy NLR, PLR and LMR on the prognosis of patients with brain metastases and analysis of related factors[J]. Journal of Molecular Imaging, 2023, 46(1): 43-47. doi: 10.12122/j.issn.1674-4500.2023.01.08

NLR、PLR和LMR对脑转移瘤患者全脑放疗预后的影响及相关因素分析

doi: 10.12122/j.issn.1674-4500.2023.01.08
基金项目: 

广东省医学科学技术研究项目基金 A2019315

详细信息
    作者简介:

    吕凤泉,放疗技师,E-mail: lvfengquan@gdph.org.cn

    通讯作者:

    邓官华,放疗物理师,E-mail: gh.deng@foxmail.com

Effect of pre-radiotherapy NLR, PLR and LMR on the prognosis of patients with brain metastases and analysis of related factors

  • 摘要:   目的  探讨放疗前外周血中性粒细胞-淋巴细胞比值(NLR)、血小板-淋巴细胞比值(PLR)及淋巴细胞-单核细胞比值(LMR)对脑转移患者全脑放疗预后的影响。  方法  回顾性纳入118例脑转移患者的临床资料,分析各个炎性复合指标和临床资料与脑转移瘤患者全脑放疗预后的关系。采用ROC曲线确定脑转移瘤患者全脑放疗预后NLR、PLR及LMR的临界值。采用Kaplan-Meier法进行单因素生存分析、Log-rank检验进行各组生存率之间的比较,采用Cox比例风险模型进行多因素回归分析。  结果  118例脑转移瘤患者的中位生存期为12.5月,1年、2年生存率分别为72.8%和50.1%。通过ROC曲线确定NLR、PLR和LMR的临界值分别为4.28、217.8和1.95。Kaplan-Meier单因素分析显示,肿瘤分期、靶向治疗、NLR、PLR以及LMR均是影响脑转移瘤患者全脑放疗预后的危险因素(P=0.001、0.032、0.008、0.003、0.002),进一步多因素Cox回归分析表明PLR是唯一的独立不良预后因素(P=0.003)。  结论  放疗前外周血PLR升高是脑转移瘤患者全脑放疗的独立不良预后因素。

     

  • 图  1  脑转移瘤患者全脑调强放疗计划布野示意图

    Figure  1.  Schematic diagram of intensity-modulated radiotherapy plan for patient metastasis.

    图  2  脑转移瘤患者全脑放疗预后NLR、PLR及LMR的受试者工作特征曲线

    Figure  2.  Receiver operating characteristic curve of the patients with brain metastasis treated with whole brain radiotherapy according to the NLR, PLR and LMR.

    图  3  118例脑转移患者总体生存曲线

    Figure  3.  The OS curve of 118 patients with brain metastasis.

    图  4  118例脑转移患者不同NLR(A)、PLR(B)、LMR(C)的生存曲线

    Figure  4.  Overall survival curves of 118 patients with brain metastasis treated with whole brain radiotherapy according to NLR (A), PLR(B), and LMR(C).

    表  1  118例脑转移患者总生存期的单因素分析结果

    Table  1.   Univariate analyses of OS in 118 patients with brain metastases

    临床特征 例数(n χ2 P 临床特征 例数(n χ2 P
    性别 0.962 0.330 化疗 0.204 0.650
       男 47    是 83
       女 71    否 35
    年龄(岁) 2.310 0.130 手术 2.97 0.085
        ≤ 70 86    是 104
        > 70 32    否 14
    卡氏功能 0.625 0.430 靶向治疗 4.570 0.032
        ≤ 70 67    是 79
        > 70 51    否 39
    脑转移数目 0.164 0.690 NLR 6.950 0.008
        ≤ 3 31     ≤ 4.28 62
        > 3 87     > 4.28 56
    颅外转移 0.098 0.750 PLR 8.610 0.003
       是 57     ≤ 217.8 35
       否 61     > 217.8 83
    肿瘤分期 10.300 0.001 LMR 9.980 0.002
       T1~T2 61     ≤ 1.95 29
       T3~T4 23     > 1.95 89
    NLR: 中性粒细胞-淋巴细胞比值; PLR: 血小板-淋巴细胞比值; LMR: 淋巴细胞-单核细胞比值.
    下载: 导出CSV

    表  2  118例脑转移患者总生存期的多因素Cox回归分析

    Table  2.   Multivariate Cox risk regression model analysis of OS in 118 patients with brain metastases

    临床因素 B S.E. Wald HR (95% CI) P
    肿瘤分期(T3~T4 vs T1~T2) 1.046 0.564 -1.87 2.845 (0.942~8.588) 0.064
    手术(是vs否) -0.657 0.709 -0.93 2.298(0.962~5.490) 0.354
    靶向治疗(否vs是) -0.832 0.444 1.85 0.519 (0.129~2.082) 0.061
    NLR (>4.28vs≤4.28) -0.524 0.735 -0.71 0.592 (0.140~2.500) 0.476
    PLR (≤217.8vs>217.8) 2.012 0.670 3.00 0.134 (0.035~0.497) 0.003
    LMR (≤1.95vs>1.95) -1.121 0.731 -1.53 3.067 (0.732~12.848) 0.125
    下载: 导出CSV
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  • 收稿日期:  2022-06-10
  • 网络出版日期:  2023-01-18
  • 刊出日期:  2023-01-20

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