| ObjectiveTo investigate the association between preoperative Neutrophil-to-Lymphocyte Ratio(NLR),Monocyte-to-Lymphocyte ratio(MLR),Platelet-to-Lymphocyte ratio(PLR)and clinicopathologic features,and according to a combined score to analyze the prognosis of patients with endometrial cancer(EC).MethodsA retrospective analysis from November 2012 to December 2016,351 cases of EC patients that met qualifying criteria for the study treated in the Department of Obstetrics and Gynecology of Tianjin Medical University General Hospital and all patients were diagnosed with EC.Collecting the age,blood routine examination within one week before surgery,preoperative tumor markers and clinicopathological datas,etc.Using spss-19.0 statistical software for statistical analysis.P < 0.05 was considered statistically significant.Results1.A total of 351 EC patients were included in this study,with an average age of58.25±9.70 years.With the development of tumor,N and M counts in patients with EC increased,L decreased,meanwhiles,NLR,MLR,and PLR increased,suggesting that the patients' anti-tumor immune response was low,and the inflammatory response was enhanced.2.According to the following-up results of the patients and ROC curves,the cut-offs of NLR,MLR and PLR were 2.11 ? 0.16 and 155.63.Combined scoring groups for NLR,MLR and PLR: combined score of 3,45 cases(12.8%);combined score of 2,81 cases(23.1%);combined score of 1,225 cases(64.1 %).3.The univariate analysis identified high score groups,pathological type,histological type,FIGO stage,myometrial invasion were potential predictors of DFS and OS.A multivariate analysis confirmed that pathological type(except for endometrioid)(HR= 20.254,P = 0.006)and FIGO stage(?+?)(HR = 5.890,P =0.016)were an independent risk factor for OS.The combined score of 3(HR =3.729,P = 0.020)?FIGO stage(?+?)(HR = 3.539,P = 0.033)were an independentrisk factor for DFS.In patients with better prognosis of stage I type I EC patients,high score groups relapse easily and have poor prognosis.Although difference has no statistical significance(p = 0.075),it prompts that high score groups may be potential predictors of DFS,having a certain value to predict their prognosis.4.In the patients with serous and others pathological subtype,FIGO ?+?or adnexa involvement,the proportion of high score groups increased obviously(P =0.005,P = 0.021,P = 0.014).ConclusionWith the development of tumor,N and M counts in patients with EC increased,L decreased,meanwhiles,NLR,MLR,and PLR increased,suggesting that the patients' anti-tumor immune response was low,and the inflammatory response was enhanced.Patients with high combined score,Pathological type II,FIGO III+IV,high-grade and myometrial invasion ?1/2 were more likely to have recurrence and death.What's more,their overall survival time,disease-free survival time was short and prognosis was also poor.Pathological type II and FIGO III+IV are independent risk factors for OS in EC patients.The high combined score group and FIGO III+IV are independent risk factors for DFS in EC patients.In patients with better prognosis of stage I type I EC patients,patients with high scores had a short DFS and a poor prognosis,suggesting that these patients should be followed up on a regular basis after surgery,and should pay more attention to tumor recurrence and disease.The high combined score groups in EC patients indicate that the tumor is more malignant and poorly differentiated,with a later stage and the possibility of attachment metastasis.Therefore,the combined scoring of NLR,MLR and PLR can be used as a predictive marker for assessing the progression and recurrence of EC patients,and it has certain reference value for the pre-treatment assessment and the choice of adjuvant therapy.Peripheral blood can be sampled for multiple times,and blood collection is convenient.At the same time,blood test are easily accepted by patients which is the most commonly used ideal material for diagnosing diseases. |
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