Evaluation Of The Effect Of Peripheral Blood Inflammation Scores On Prognosis In Patients With Concomitant Hypertensive Lung Cancer Resection

BackgroundLung cancer is one of the malignant tumors with high morbidity and mortality in the world,and new cases are increasing year by year.At present,the most commonly used clinical indicators to evaluate the survival and prognosis of lung cancer patients include age,comorbidities,tumor TNM stage,etc.,while the hot spots in the clinical research literature mainly focus on lymphocytes,neutrophils,monocytes,platelets,etc.Prediction of the impact of inflammation scores formed by peripheral blood cell parameters on prognosis in cancer patients.At the same time,some studies have shown that the peripheral blood inflammation score also has a certain influence on patients with hypertension.With the increasing number of hypertensive patients and lung cancer patients year by year,the research on the survival prognosis of lung cancer patients with hypertension becomes more and more important,and there is an urgent need to find simple indicators that can predict the survival prognosis of this population.PurposeIn this paper,the ratio（LMR）of the number of lymphocytes（L）to the number of monocytes（M）,the ratio（NLR）of the number of neutrophils（N）and the number of lymphocytes（L）and the number of platelet（P）and the number of lymphocytes（PLR）were used as research indicators to explore the predictive value of LMR,NLR and PLR values for their prognosis.MethodsThis study retrospectively analyzed the clinical data of patients with hypertension who underwent lung cancer surgery in Xinxiang Central Hospital from January 2014 to July 2018,and calculated the required LMR,NLR,and PLR values according to the lymphocyte count,monocyte number,neutrophil number,platelet number,etc.in the blood test results within three days after the operation,and divided the patients into high LMR group（≥2.14,n=67 cases）and low LMR group（<2.14,n=148 cases）according to the ratio.The high NLR group（≥17.2,n=37 cases）and the low NLR group（<17.2,n=178 cases）,the high PLR group（≥311.6,n=46 cases）and the low PLR group（<311.6,n=169 cases）.Comparing clinical case data between patient groups,Kaplan-Meier method was used to plot survival curves;Log-rank test compared OS and PFS differences between patient groups;chi-square test compared differences between groups;Univariate and multivariate analysis of COX risk regression models was used to screen for independent risk factors affecting the survival prognosis of general anesthesia surgery in lung cancer patients with hypertension.ResultsThe results of univariate analysis showed that the factors associated with OS were age,tumor TNM stage,degree of tumor differentiation,LMR value,NLR value,PLR value,operation duration,duration of anesthesia,intraoperative bleeding,etc.The difference was statistically significant（P<0.05）,and the factors associated with PFS were tumor TNM stage,tumor differentiation degree,LMR value,NLR value,PLR value,surgical length,inhalation of anesthetics,intraoperative bleeding,etc.The difference was statistically significant（P<0.05）.However,there were no statistically significant differences in sex,tumor site,dexmedetomidine,and urine output（P>0.05）.The inclusion of research indicators into the results of COX multifactorial analysis showed that tumor TNM stage,LMR value,NLR value,etc.were independent influencing factors of patient’ OS and PFS,intraoperative bleeding volume was an independent influencing factor of patients’ PFS,while the difference in PLR value in multivariate analysis results was not statistically significant（P>0.05）,which was not an independent influencing factor of patient survival prognosis.Conclusions1.Postoperative LMR value and NLR value are independent risk factors for postoperative survival of lung cancer patients with hypertension,which can be used as clinical survival predictors,which are simple and easy to obtain,and guide the formulation of clinical treatment plans;2.The survival prognosis of the patients in the high LMR group was significantly better than that of the patients in the low LMR group,and the survival prognosis of the patients in the low NLR group was significantly better than that of the patients in the high NLR group,and the postoperative survival time was significantly prolonged;3.The predictive value of postoperative PLR value on postoperative survival of lung cancer patients with hypertension lacks evidence support,and its value is limited.