Prediction of outcomes after chemoradiotherapy for cervical cancer by neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio.

IF 0.9 4区医学 Q4 OBSTETRICS & GYNECOLOGY Journal of Obstetrics and Gynaecology Pub Date : 2024-12-01 Epub Date: 2024-06-12 DOI:10.1080/01443615.2024.2361858

Jing Yu, Longzhang Huang, Ting Dong, Lihua Cao

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Abstract

Background: Cervical cancer ranks as the second most fatal tumour globally among females. Neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) have been widely applied to the diagnosis of cancers.

Methods: The clinicopathologic data of 180 patients with stage IB2-IIB cervical cancer who underwent radical concurrent chemoradiotherapy from January 2018 to December 2019 were retrospectively analysed. Receiver operating characteristic (ROC) curves were plotted to analyse the optimal cut-off values of NLR and PLR for predicting the therapeutic effects of concurrent chemoradiotherapy. The associations of PLR and other clinicopathological factors with 1-year survival rates were explored through univariate analysis and multivariate Cox regression analysis, respectively.

Results: NLR was significantly associated with the therapeutic effects of neoadjuvant therapy, with the optimal cut-off value of 2.89, area under the ROC curve (AUC) of 0.848 (95% confidence interval [CI]: 0.712-0.896), sensitivity of 0.892 (95% CI: 0.856-0.923) and specificity of 0.564 (95% CI: 0.512-0.592). PLR had a significant association with the therapeutic effects of neoadjuvant therapy, with the optimal cut-off value of 134.27, AUC of 0.766 (95% CI: 0.724-0.861), sensitivity of 0.874 (95% CI: 0.843-0.905) and specificity of 0.534 (95% CI: 0.512-0.556). Lymphatic metastasis ([95% CI: 1.435-5.461], [95% CI: 1.336-4.281], depth of invasion ([95% CI: 1.281-3.546], [95% CI: 1.183-3.359]) and tumour size ([95% CI: 1.129-3.451], [95% CI: 1.129-3.451]) were independent factors influencing the overall survival and disease-free survival (DFS) of patients with cervical cancer. NLR (95%CI: 1.256-4.039) and PLR (95%CI:1.281-3.546) were also independent factors affecting DFS.

Conclusion: NLR and PLR in the peripheral blood before treatment may predict DFS of patients with stage IB2-IIB cervical cancer.

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通过中性粒细胞与淋巴细胞比率和血小板与淋巴细胞比率预测宫颈癌化疗后的预后。

背景：宫颈癌是全球女性第二大致命肿瘤。中性粒细胞与淋巴细胞比值（NLR）和血小板与淋巴细胞比值（PLR）已被广泛应用于癌症诊断：回顾性分析2018年1月至2019年12月接受根治性同期化放疗的180例IB2-IIB期宫颈癌患者的临床病理资料。绘制接收者操作特征曲线（ROC），分析NLR和PLR预测同期化放疗疗效的最佳临界值。通过单变量分析和多变量Cox回归分析，分别探讨了PLR和其他临床病理因素与1年生存率的关系：NLR与新辅助治疗的疗效明显相关，最佳临界值为2.89，ROC曲线下面积（AUC）为0.848（95%置信区间[CI]：0.712-0.896），灵敏度为0.892（95% CI：0.856-0.923），特异性为0.564（95% CI：0.512-0.592）。PLR与新辅助治疗的疗效有明显关联，最佳临界值为134.27，AUC为0.766（95% CI：0.724-0.861），灵敏度为0.874（95% CI：0.843-0.905），特异性为0.534（95% CI：0.512-0.556）。淋巴转移（[95% CI：1.435-5.461]，[95% CI：1.336-4.281]）、浸润深度（[95% CI：1.281-3.546]，[95% CI：1.183-3.359]）和肿瘤大小（[95% CI：1.129-3.451]，[95% CI：1.129-3.451]）是影响宫颈癌患者总生存期和无病生存期（DFS）的独立因素。NLR（95%CI：1.256-4.039）和PLR（95%CI：1.281-3.546）也是影响无病生存期的独立因素：结论：治疗前外周血中的 NLR 和 PLR 可预测 IB2-IIB 期宫颈癌患者的 DFS。

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来源期刊

Journal of Obstetrics and Gynaecology 医学-妇产科学

CiteScore

2.40

自引率

7.70%

发文量

398

审稿时长

6 months

期刊介绍： Journal of Obstetrics and Gynaecology represents an established forum for the entire field of obstetrics and gynaecology, publishing a broad range of original, peer-reviewed papers, from scientific and clinical research to reviews relevant to practice. It also includes occasional supplements on clinical symposia. The journal is read widely by trainees in our specialty and we acknowledge a major role in education in Obstetrics and Gynaecology. Past and present editors have recognized the difficulties that junior doctors encounter in achieving their first publications and spend time advising authors during their initial attempts at submission. The journal continues to attract a world-wide readership thanks to the emphasis on practical applicability and its excellent record of drawing on an international base of authors.