Exploration Of The Clinical Value Of NLR,PLR,MLR And PNI In Nasopharyngeal Carcinoma

Objective:To explore the clinical value of platelet to lymphocyte ratio?PLR?,neutrophil to lymphocyte ratio?NLR?,monocyte to lymphocyte ratio?MLR?and prognostic nutritional index?PNI?in 174 patients with nasopharyngeal carcinoma?NPC?.Methods:Blood routine indexes and biochemistry indexes of 174 patients with pathologically confirmed nasopharyngeal carcinoma?62 recurrence patients and 112 non-relapsed patients?and 100 normal people were collected.The absolute value of neutrophils,lymphocyte,monocyte,platelet count,albumin level are recorded and NLR,PLR,MLR,PNI are computed.The differences of NLR,PLR,MLR and PNI are compared between the normal group,NPC group,NPC recurrence group and NPC non-relapsed group,and the clinicopathological parameters of patients with NPC are statistically analyzed.Results:1.Before treatment,NLR,MLR and PLR in the NPC group are higher than those in the normal group,while PNI is lower than those in the normal group,and the difference is significant?P<0.05?.Before treatment,NLR,MLR and PLR in the recurrence group are higher than those in the non-relapsed group,while PNI is lower than those in the non-relapsed group,and the difference was statistically significant?P<0.05?.2.The difference of NLR between cervical lymph node metastasis and those without cervical lymph node metastasis is statistically significant?P<0.05?,and the difference of PLR,MLR,PNI between two groups is of no statistical significance?P>0.05?.There are statistically significant differences in PLR,MLR,and PNI between groups of T₁+T₂ and T₃+T₄ group?all P<0.05?,and there is no significant difference in NLR between the two groups?P>0.05?.The difference of NLR,MLR and PNI between stage?+?group and stage?+?group is statistically significant?P<0.05?,and the difference of PLR between two groups is no statistical significance?P>0.05?.There are no statistically significant differences in NLR,PLR,MLR,and PNI among the three groups of different pathological typing?undifferentiated non-keratotic carcinoma,differentiated non-keratotic carcinoma and low differentiated squamous cell carcinoma??P>0.05?.3.The recurrence rate of patients under or equal to 48 and patients over 48 is 40.000%?36/90?and 30.952%?26/84?,and there is no statistically significant difference between the groups?P=0.277?.The recurrence rate of male patients and female patients after treatment is 41.409%?53/129?and20.000%?9/45?,and the difference between the groups is statistically significant?P=0.015?.The recurrence rate of T₁+T₂ and T₃+T₄ in NPC is 21.429%?15/70?and45.192%?47/104?,and the difference between the groups is statistically significant?P=0.002?.The recurrence rate of cervical lymph node metastasis and those without cervical lymph node metastasis is 35.329%?59/167?and 42.857%?3/7?,and there is no statistically significant difference between the groups?P=0.485?.The recurrence rate in clinical stage?+?and?+?in NPC was 0?0/19?,40.000%?62/155?,and the difference between the groups is statistically significant?P=0.003?.The recurrence rate of patients with undifferentiated non-keratotic carcinoma,differentiated non-keratotic carcinoma and low differentiated squamous cell carcinoma is 34.615%?54/156?,40.000%?2/5?and 46.154%?6/13?,and there is no statistically significant difference between the groups?P=0.660?.The recurrence rate is 20.225%?18/89?and 51.765%?44/85?in the low-NLR and high-NLR groups,respectively.The recurrence rate is 27.500%?33/120?and53.704%?29/54?in the low-PLR and high-PLR groups,respectively.The recurrence rate is 26.923%?28/104?and 48.571%?34/70?in the low-MLR and high-MLR groups,respectively.The recurrence rate is 57.894%?44/76?and18.367%?18/98?in the low-PNI and high-PNI groups,respectively.The difference of gender,T stage,clinical stage,NLR,PLR,MLR and PNI between the groups are statistically significant?all P<0.05?.The result of single factor analysis indicates that gender,T stage,clinical stage,NLR,PLR,MLR,PNI are associated with the recurrence in NPC?P<0.05?.And age,lymph node metastasis and pathological type are not associated with the recurrence in NPC?P>0.05?.Multivariate analysis suggests that PNI is an independent prognostic factor influencing the recurrence of NPC.Conclusions:1.The differences of NLR,MLR,PLR and PNI are significant between the patients with the NPC group and the normal group,and the differences are obvious between the recurrence group and the non-relapsed group.It is indicated that NLR,MLR,PLR,PNI and NPC are clinically relevant,especially recurrent NPC.2.Before the treatment in patients with NPC,the levels of NLR may be associated with lymph node metastasis,the levels of PLR,MLR and PNI may be associated with T stage,the levels of NLR,MLR and PNI may be associated with clinical stage.3.T stage,NLR,MLR,PLR,PNI and gender are the factors that affect the recurrence of patients with NPC.PNI may be an independent factor that influences the prognosis of patients with NPC.