Peripheral Neutrophil-Lymphocyte Ratio and Platelet-Lymphocyte Ratio Predict the Prognosis of Liver, Colorectal, Breast and Lung Cancers

末稍血液中性白血球－淋巴球比率及血小板－淋巴球比率對肝癌、大腸癌、乳癌及肺癌之預後預估

柯成國(Chen-Guo Ker) ； 李旬千(Chun-Chaing Lee) ； 董弘一(Hong-I Tong) ； 陳昱甫(Yu-Fu Chen) ； 王柏為(Bo-Wei Wang) ； 柯秋滿(Chiu-Man Ko) ； 蔡蕙婷(Hui-Ting Tsai) ； 趙錦沂(Chin-Yi Chao) ； 盧佳伶(Chia-Ling Lu) ； 孫筱竼(Hsiao-Fan Sun) ； 施昇良(Shen-Liang Shih) ； 陳碧芳(Pi-Fang Chen)

《南臺灣醫學雜誌》 15卷2期 (2019/12) Pp. 68-78

https://doi.org/10.6726/MJST.201912_15(2).0001

摘要

Objective: Four major cancers; liver, colorectal, breast and lung cancers had become top-4 leading causes of death in Taiwan. The clinical features will effect on survival rate and should be recognized as alarming features for treatment plan. Therefore, we try to establish this study to investigate the neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) from our routine blood examination during practice as a predictor of prognosis of top 4 major cancers. Methods: Top four major cancers included liver, colorectal, breast and lung cancer were registered in the hospital-based Cancer Registry Center and accepted treatment in our hospital from 2007 to 2011. Top 4-cancer patients enrolled for liver, colorectal, breast and lung cancers were 526, 377, 574, and 661. All patients were received treatment in our hospital. Patient's peripheral neutrophil, lymphocyte and platelet count were used for study. The scales of NLR and PLR were derived from the lower and higher normal range in cell count for neutrophil, lymphocyte and platelet. Therefore, the scales for NLR were≦1.62, 1.63-2.57, ≧2.58, and for PLR were≦224, 225-253, ≧254 respectively. Our aim was to analyze the prognostic impact of NLR and PLR on 1-yr, 3-yr, and 5- year survival rates based on their ratio scales. Results: These patients' age, gender, TMN staging, and surgical resection status were recorded for analysis. These patients received surgical resection in 131(24.9%), 361(95.8%), 574(100%), and 74(11.2%) of liver, colorectal, breast and lung cancers. Their mean survival times were shorter in the patients of high score of NLR≧2.58. The survival curves demonstrated poor prognosis of 4-cancer patients especially in liver and lung cancers. It seemed that the survival trend was poor significantly (p＜0.05) in patients with NLR≧2.58 in all 4-cancer. The 5-year mortality were founded in patients if PLR≧ 254 were 80 (88.9%), 80(61.1%), 11(36.7%) and 169(88.9%) for liver, colorectal, breast and lung cancers respectively. It demonstrated that the survival trend was poorest significantly (p=0.001). Conclusions: NLR and PLR are easily to take and calculate in our clinical practice and have potential roles as predictors of prognosis. Declined either NLR or PLR can have a better survival in top 4-cancer.

關鍵字

neutrophil-lymphocyte ratio ； platelet-lymphocyte ratio ； cancer ； survival rate

並列摘要

目的：台灣前四名癌症是肝癌、大腸癌、乳癌及肺癌。其臨床症況會影響預後而且在照護上需要警覺預估其預後。因此本研究將計算容易取得之末稍血液中性白血球－淋巴球及血小板－淋巴球比率對台灣四大癌症之預後預估。方法：台灣前四名癌症肝癌、大腸癌、乳癌及肺癌在本院診斷及治療且登記在癌症中心之病人數，在2007－2011年間分別肝癌526、大腸癌377、乳癌574及肺癌661位為研究對象。病人之末稍血液中性白血球（N）、淋巴球（L）及血小板（P）數目取得以供計算中性白血球－淋巴球比率（NLR）及血小板－淋巴球比率（PLR）。因N、L及P之正常值範圍上下限，因此取得NLR及PLR之三組距NLR是≦1.62、1.63－2.57、≧2.58在PLR是≦224、225－253、≧254。此組群病人1年、3年及5年之生存率之相關性統計分析。結果：台灣前四名癌症病人之年齡、性別、TMN期別及手術切除等資料。有接受手術切除者肝癌、大腸癌、乳癌及肺癌分別為131（24.9%）、361（95.8%）、574（100%）及74（11.2%）。整體而言如果NLR≧2.58時其四大癌症之預後較差（p＜0.05）。但PLR≧254時只肝癌、乳癌及肺癌較不好（p=0.001）。全體5年死亡病人數及佔率在肝癌、大腸癌、乳癌及肺癌分別為80（88.9%）、80（61.1%）、11（36.7%）及169（88.9%）。結論：取得NLR及PLR在平常血液檢驗中簡易可得，注意如何降低NLR或PLR值時在四大癌症中會具有較好的預後的。

並列關鍵字

中性白血球－淋巴球比率 ； 血小板－淋巴球比率 ； 癌症 ； 生存率