外周血炎症指标与口腔鳞状细胞癌患者术后复发转移相关性研究

Correlation of multiple inflammatory indices in peripheral blood with postoperative recurrence and metastasis in oral squamous cell carcinoma patients

摘要

目的 探讨手术前后中性粒细胞-淋巴细胞比值（neutrophil-to-lymphocyte ratio，NLR）、血小板-淋巴细胞比值（platelet-to-lymphocyte ratio，PLR）、淋巴细胞-单核细胞比值（lymphocye-to-monocyte ratio，LMR）、全身免疫炎症指数（systemic immune-inflammation index，SII）、系统性炎症反应指数（systemic inflammation response index，SIRI）等外周血炎症指标与口腔鳞状细胞癌（oral squamous cell carcinoma，OSCC）患者术后复发转移的相关性，为临床评估OSCC患者的预后提供参考。方法 本研究通过医院伦理委员会批准，并获得患者知情同意。对行OSCC根治术的160例原发性OSCC患者，收集其术前最后一次和术后1个月血常规，根据是否术前淋巴结转移、分化程度、临床T分期以及是否术后复发转移分组，分析OSCC患者NLR、PLR、LMR、SII、SIRI等外周血炎症指标与以上临床病理指标、术后复发转移的关系。结果 160例OSCC患者，术前淋巴结转移和无转移组的术前SII差异有统计学意义（P<0.05）；术前NLR、SII、SIRI在不同分化程度组间差异有统计学意义（P<0.05）；不同临床T分期组的术前SIRI指标差异有统计学意义（P<0.05）。术前NLR、PLR、SII、SIRI在术后复发转移组和无复发转移组间的差异有统计学意义（P<0.05），术后外周血炎症指标与术后复发转移无关。单因素Cox分析显示：术前外周血炎症指标中，术前NLR、PLR、SII、SIRI是影响OSCC患者复发转移的影响因素；多因素Cox分析结果显示：术前外周血炎症指标中，只有术前NLR是影响患者复发转移的独立危险因素。结论 外周血炎症指标中，术前NLR是OSCC患者术后复发转移的独立危险因素，有一定的预测价值。

Abstract

Objective To investigate the associations of multiple immunoinflammatory markers in peripheral blood before and after operation, such as the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), systemic immune-inflammation index (SII) and systemic inflammatory response index (SIRI), with postoperative recurrence and metastasis in oral squamous cell carcinoma (OSCC) patients, to provide a reference for predicting the prognosis of OSCC patients. Methods This study was approved by the hospital ethics committee, and informed consent was obtained from the patients. A total of 160 patients with primary OSCC who underwent radical surgery were grouped according to preoperative lymph node metastasis, degree of differentiation, clinical T stage, and postoperative recurrence and metastasis. The last preoperative and 1-month postoperative routine blood test results of all the patients were collected to analyze the relationship between peripheral blood inflammatory indicators, including the NLR, PLR, LMR, SII, and SIRI, before and after surgery.The above clinicopathological indicators and postoperative recurrence and metastasis were evaluated in OSCC patients. Results Among the 160 patients, there was a significant difference in the preoperative SII between the preoperative lymph node metastasis group and the no metastasis group (P<0.05); the preoperative NLR, LMR, SII and SIRI were significantly different among the different differentiation degree groups (P<0.05); and the preoperative SIRI in the different clinical T stage groups were significantly different (P<0.05). The preoperative NLR, SII and SIRI were significantly different between the postoperative recurrence and metastasis group and the no recurrence and metastasis group (P<0.05). Postoperative peripheral blood inflammatory markers were not associated with postoperative metastasis and recurrence. Univariate Cox analysis revealed that among the preoperative peripheral blood inflammatory indicators, the preoperative NLR, PLR, SII and SIRI were the factors influencing recurrence and metastasis in OSCC patients. Multivariate Cox analysis revealed that the preoperative NLR was the only independent risk factor for recurrence and metastasis in OSCC patients among the preoperative peripheral blood inflammatory indicators. Conclusion Among the peripheral blood inflammatory indicators, the preoperative NLR is an independent risk factor for postoperative recurrence and metastasis in OSCC patients and has certain predictive value.

关键词

口腔鳞状细胞癌 / 中性粒细胞-淋巴细胞比值 / 血小板-淋巴细胞比值 / 全身免疫炎症指数 / 系统性炎症反应指数 / 临床T分期 / 术前淋巴结转移 / 预后 / 复发转移

Key words

oral squamous cell carcinoma / neutrophil-to-lymphocyte ratio / platelet-to-lymphocyte ratio / systemic immune-inflammation index / systemic inflammation response index / clinical T stage / preoperative lymph node metastasis / prognosis / recurrence and metastasis

Author summay

姑海尔尼沙·开合热曼，硕士研究生，Email：[e-mail]