A Study Of The Correlation Of Peripheral Neutrophil To Lymphocyte Ratio With The Prognosis Of Nasopharyngeal Carcinoma

Purpose: Nasopharyngeal carcinoma(NPC)is a high-incident malignant tumor in southern China,especially in Guangdong and Guangxi province.The prognosis ofNPC is poor,which seriously affects people’s life and health.Therefore,it is very important to evaluate the prognosis of this tumor.In recent years,many studies have shown that the neutrophil to lymphocyte ratio(NLR)of peripheral blood is closely related to the prognosis of many malignant tumors,but few studies on NPC have been reported.The purpose of this study was to further evaluate the prognostic value of NLR in patients with NPC.Methods: We collected 212 NPC patients which were treated in Affiliated Tumor Hospital of Guangxi Medical University fromJuly 2006 to June 2007,and retrospectively analyzed their clinical data.These patients are long-lived residents from Guangxi.SPSS was used to analyze the effects of age,sex,tobacco and alcohol history,NLR,T stage,clinical stage and chemotherapy onthe disease free survival time(DFS)and the overall survival(OS)of these patients.The follow-up results were obtained through telephone mainly by the members of our research group and the department charging in tumor patient follow-up of our hospital.Follow-up data of part of the patients were also obtained from the diagnosis and treatment records of out-patient and in-patient department of our hospital.Results: univariate analysis showed that the OS ofNPC patients with male(P=0.034),age>=44 years(P=0.039),high NLR level(>=2.14)(P=0.000),T3-T4 stage(P=0.001)and Ⅲ-Ⅳ stage(P=0.024)were significantly poorer than female,age<44 years,low NLR level(<2.14),T1-T2 stage and Ⅰ-Ⅱstage.The DFS in patients with high NLR level(>= 2.14)(p=0.004),T3-T4 stage(p=0.006)and Ⅲ-Ⅳstage(p=0.024)were significantly poorer than low NLR level(<2.14),T3-T4 stage and Ⅰ-Ⅱstage.There were no significant correlations between age(P=0.317),sex(P = 0.317,0.068)and DFS.There were no significant correlations between smoking and drinking history,chemotherapy,N stage,clinical stagingand OS(p values were0.189、0.203、0.468、0.892、0.159respectively)as well as DFS(p values were0.329、0.477、0.632、0.232、0.156respectively)of NPC patients.Multivariate analysis showed that NLR level(HR=2.421,95%CI=1.135-5.155,p=0.022),age(HR=2.066,95%CI=1.018-4.202,p=0.044)were independent risk factors for OS of NPC patients,but only NLR level was an independent risk factor for DFS(HR=1.901,95%CI=1.076-3.355,p=0.027).Conclusion: High NLR level is associated with poor OS and DFS in NPC patients,and may be an independent risk factor in predicting the risk of death and recurrence or distant metastasis in NPC patients.