Background

Neutrophil-to-lymphocyte ratio (NLR) has been used as an inflammation based prognostic marker for various malignancies. This study evaluated the association between NLR and overall survival (OS) in patients with metastatic gallbladder cancer (GBC)

Methods

An optimal cut off point for NLR was identified by plotting spline-based hazard ratio curves to identify a threshold effect and patients were divided into two groups, ≥5 or <5. Kaplan–Meier curves were plotted for NLR≥5 and NLR<5 and OS between the two groups.

Results

Of the 231 patients included, 138 (60%) had NLR <5 and 93 (40%) had NLR ≥5. There were no significant differences noted in gender, race, and administration of chemotherapy between the two groups. On univariable analysis, patients with NLR ≥5 had a significantly poor OS compared to those with NLR <5 (Median OS: 3.6 vs 8.7 months, p < 0.001). On multivariable analysis, adjusting for age, performance status, albumin, alkaline phosphatase, alanine aminotransferase, aspartate aminotransferase, bilirubin, platelet count and no administration of chemotherapy, NLR of ≥5 was associated with a worse OS compared to NLR <5 (HR: 1.70, 95%CI:1.20–2.39, p < 0.05).

Conclusion

The current study demonstrates that NLR ≥5 is an independent predictor of poor prognosis in patients with metastatic GBC.

中文翻译：

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中性粒细胞与淋巴细胞的比率作为转移性胆囊癌的预后标志物。

背景

中性粒细胞与淋巴细胞比率 (NLR) 已被用作各种恶性肿瘤的基于炎症的预后标志物。本研究评估了转移性胆囊癌 (GBC) 患者的 NLR 与总生存 (OS) 之间的关联

方法

通过绘制基于样条的风险比曲线来确定阈值效应，确定了 NLR 的最佳截止点，并将患者分为两组，≥5 或 <5。绘制两组间 NLR≥5 和 NLR<5 以及 OS 的 Kaplan-Meier 曲线。

结果

在包括的 231 名患者中，138 名 (60%) 的 NLR <5 和 93 (40%) 名 NLR ≥5。两组之间在性别、种族和化疗给药方面没有显着差异。在单变量分析中，与 NLR <5 的患者相比，NLR ≥5 的患者的 OS 显着较差（中位 OS：3.6 个月 vs 8.7 个月，p < 0.001）。在多变量分析中，校正年龄、体能状态、白蛋白、碱性磷酸酶、丙氨酸氨基转移酶、天冬氨酸氨基转移酶、胆红素、血小板计数和未接受化疗后，与 NLR <5 相比，NLR ≥ 5 与较差的 OS 相关（HR： 1.70，95% CI：1.20–2.39，p < 0.05）。

结论

目前的研究表明，NLR≥5 是转移性 GBC 患者预后不良的独立预测因子。