中国口腔颌面外科杂志

中国口腔颌面外科杂志 ›› 2023, Vol. 21 ›› Issue (6): 566-571.doi: 10.19438/j.cjoms.2023.06.006

• 论著 • 上一篇    下一篇

基于基线期dNLR水平对局部晚期口腔鳞癌患者生存的预后预测—10年临床回顾

朱方兴, 周知航, 琚梧桐, 谈亦然, 刘莹, 钟来平*, 赵铜超*   

  1. 上海交通大学医学院附属第九人民医院 口腔颌面-头颈肿瘤科,上海交通大学口腔医学院, 国家口腔医学中心,国家口腔疾病临床医学研究中心,上海市口腔医学重点实验室, 上海市口腔医学研究所,上海 200011
  • 收稿日期:2023-02-25 修回日期:2023-05-26 出版日期:2023-11-20 发布日期:2023-12-07
  • 通讯作者: 赵铜超,E-mail: zhaotongchao@gmail.com;钟来平,E-mail: zhonglaiping@163.com。*共同通信作者
  • 作者简介:朱方兴（1994-）,男,博士,E-mail: sp_terry94@163.com
  • 基金资助:
    上海市科学技术委员会启明星项目扬帆专项（22YF1421700）

Baseline derived neutrophil to lymphocyte ratio predicting the prognosis of local advanced oral squamous cell carcinoma: a retrospective study over 10 years

ZHU Fang-xing, ZHOU Zhi-hang, JU Wu-tong, TAN Yi-ran, LIU Ying, ZHONG Lai-ping, ZHAO Tong-chao   

  1. Department of Oromaxillofacial Head and Neck Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology; Shanghai Research Institute of Stomatology. Shanghai 200011, China
  • Received:2023-02-25 Revised:2023-05-26 Online:2023-11-20 Published:2023-12-07

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摘要： 目的: 探讨基线期中性粒细胞与淋巴细胞比率（derived neutrophils to lymphocyte ratio, dNLR）预测局部晚期口腔鳞癌患者生存预后的价值。方法: 纳入临床试验项目（NCT01542931）中接受标准治疗的局部晚期口腔鳞癌患者的基线数据和10年长期随访数据。通过绘制受试者工作曲线及计算曲线下面积,以约登指数确定预后最好时dNLR的截断值,并以此值将所纳入患者分为高dNLR组和低dNLR组,以Kaplan-Meier生存分析和单因素、多因素Cox比例风险模型,比较2组患者的生存差异和风险因素。主要结局指标是总生存时间（overall survival, OS）,次要结局指标是无瘤生存时间（disease-free survival, DFS）、无局部复发生存时间（local recurrence-free survival, LRFS）和无远处转移生存时间（distant metastasis-free survival, DMFS）。采用SPSS 25.0软件包对数据进行统计学分析。结果: 纳入局部晚期口腔鳞癌患者115例,平均年龄（54.5±10.7）岁,平均随访时间（80.3±55.5）个月;dNLR的截断值为1.555。多因素Cox比例风险模型显示,dNLR是局部晚期口腔鳞癌患者生存的独立预测指标（OS: HR=1.172, 95%CI: 1.028~1.337, P=0.018; DFS: HR=1.123, 95%CI: 1.001~1.282, P=0.050; LRFS: HR=1.137, 95%CI: 1.002~1.291, P=0.047; DMFS: HR=1.162, 95%CI: 1.020~1.324, P=0.024）。结论: dNLR是局部晚期口腔鳞癌患者生存的独立预测指标,基线期dNLR越低,患者远期总体预后越好。

关键词: 中性粒细胞与淋巴细胞比率, dNLR, 局部晚期口腔鳞癌, 预后

Abstract: PURPOSE: To investigate the value of derived neutrophils to lymphocyte ratio (dNLR) in predicting the survival and prognosis of patients with locally advanced oral squamous cell carcinoma(LAOSCC). METHODS: Patients of stage Ⅲ/ⅣA LAOSCC disease who accepted radical surgery and postoperative radiotherapy from a phase Ⅲ trial (NCT01542931) were enrolled. Based on their baseline clinical data and ten-year-follow-up visiting data, receiver operating characteristic curves (ROC) were built and area under the curve (AUC) was computed to determine dNLR cutoff points, according to Youden's index. The patients were then grouped into low dNLR group and high dNLR group. Kaplan-Meier estimates of survival and Cox proportional hazards models were used for longitudinal analysis. The primary outcome was overall survival (OS). The second outcome was disease-free survival(DFS), local recurrence-free survival(LRFS) and distant metastasis-free survival(DMFS). SPSS 25.0 software package was used for data analysis. RESULTS: A total of 115 patients with LAOSCC were enrolled in this study, with an average age of (54.5±10.7) years and an average follow-up time of (80.3±55.5) months. dNLR cutoff point was 1.555. Multivariate analysis showed dNLR was an independent negative predictive factor for survival (OS: HR=1.172, 95%CI: 1.028-1.337, P=0.018; DFS: HR=1.123, 95%CI: 1.001-1.282, P=0.050; LRFS: HR=1.137, 95%CI: 1.002-1.291, P=0.047; DMFS: HR=1.162, 95%CI: 1.020-1.324, P=0.024). CONCLUSIONS: dNLR is an independent negative predictive factor in patients with LAOSCC. Patients of lower baseline dNLR achieve better long-term prognosis.

Key words: Derived neutrophils to lymphocyte ratio, dNLR, Locally advanced oral squamous cell carcinoma, Prognosis

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