CAJ | 학술논문

目的：探讨术前中性粒细胞/淋巴细胞比值（ NLR）与卵巢癌患者的临床病理特征及预后的关系。方法回顾性分析2000年1月至2012年12月本院165例初治卵巢癌患者的临床资料，根据术前NLR值，将患者分为高NLR组（ NLR＞3）和低NLR组（ NLR≤3），比较两组患者的临床病理特征及无进展生存期（ PFS）和总生存期（ OS）。采用Cox回归模型分析影响卵巢癌患者预后的独立因素。结果卵巢癌患者术前NLR的增高与肿瘤分期晚、恶性腹水、CA125升高、手术减瘤不满意、血红蛋白降低、淋巴细胞减少以及白细胞、中性粒细胞和血小板增多有关（ P＜0?05）。高NLR组与低NLR组患者的中位PFS分别为10个月和22个月，差异有统计学意义（ P＜0?01）；两组患者的中位OS分别为28个月和63个月，差异亦有统计学意义（ P＜0?01）。单因素分析显示FIGO分期、手术减瘤程度、腹水、NLR是影响OS和PFS的因素（ P＜0?05）。 Cox多因素分析显示除FIGO分期和手术减瘤满意度外，术前NLR水平增高也是影响卵巢癌患者PFS （ HR：1?130，95％CI：1?053～1?213，P＝0?001）和OS （ HR：1?190，95％CI：1?100～1?288，P＜0?001）的独立预后因素。结论术前NLR值可作为卵巢癌患者的独立预后因素。
목적：탐토술전중성립세포/림파세포비치（ NLR）여란소암환자적림상병리특정급예후적관계。방법회고성분석2000년1월지2012년12월본원165례초치란소암환자적림상자료，근거술전NLR치，장환자분위고NLR조（ NLR＞3）화저NLR조（ NLR≤3），비교량조환자적림상병리특정급무진전생존기（ PFS）화총생존기（ OS）。채용Cox회귀모형분석영향란소암환자예후적독립인소。결과란소암환자술전NLR적증고여종류분기만、악성복수、CA125승고、수술감류불만의、혈홍단백강저、림파세포감소이급백세포、중성립세포화혈소판증다유관（ P＜0?05）。고NLR조여저NLR조환자적중위PFS분별위10개월화22개월，차이유통계학의의（ P＜0?01）；량조환자적중위OS분별위28개월화63개월，차이역유통계학의의（ P＜0?01）。단인소분석현시FIGO분기、수술감류정도、복수、NLR시영향OS화PFS적인소（ P＜0?05）。 Cox다인소분석현시제FIGO분기화수술감류만의도외，술전NLR수평증고야시영향란소암환자PFS （ HR：1?130，95％CI：1?053～1?213，P＝0?001）화OS （ HR：1?190，95％CI：1?100～1?288，P＜0?001）적독립예후인소。결론술전NLR치가작위란소암환자적독립예후인소。
Objective To investigate the relationship between preoperative neutrophil to lymphocyte ratio ( NLR) and clini-copathological characteristics, prognosis of patients with ovarian cancer. Methods The clinical data of 165 patients with newly diag-nosed ovarian cancer in our hospital were obtained from January 2000 to December 2012. All patients underwent surgery after diagnosed ovarian cancer and followed up until the deadline. The patients were divided into two groups according to the preoperative NLR: low NLR( NLR≤3) and high NLR( NLR>3) . The clinicopathological characteristics and survivals between the two groups were compared. The risk factors affecting overall survival ( OS) and progression-free survival ( PFS) in ovarian cancer were analyzed using multivariate Cox regression analysis. Results Compared to the low NLR group, the patients with high NLR had significant correlation with ad-vanced tumor stage, suboptimal surgical, malignant ascites, low hemoglobin and lymphocyte counts, high neutrophil, white blood cell and platelet counts (P<0?05). Patients with preoperative NLR>3 had significantly shorter median OS (28 months vs. 63 months) and PFS (10 months vs. 22 months) compared to those with NLR≤3 (P<0?001). The univariate analysis showed that the high risk factors affecting the survival of ovarian cancer including advanced tumor stage, malignant ascites, suboptimal surgical and increased levels of NLR ( P<0?05) . Cox?s multivariate analysis showed that preoperative NLR was an independent prognostic factor of PFS ( HR:1?130, 95%CI:1?053-1?213, P=0?001) and OS ( HR:1?190, 95%CI:1?100-1?288, P<0?001) in patients with ovarian cancer, along with tumor stage and surgical outcomes. Conclusion Preoperative NLR may be an independent prognostic factor of survival in patients with ovarian cancer.