血细胞衍生指标与神经母细胞瘤患儿2年死亡风险的关系OA
Association of blood cell-derived indices with 2-year mortality risk in children with neuroblastoma
目的 探讨血细胞衍生指标[中性粒细胞与淋巴细胞比值(NLR)、血小板与淋巴细胞比值(PLR)、系统性免疫炎症指数(SII)]与神经母细胞瘤(NB)患儿2年死亡风险的关系.方法 采用单中心回顾性队列研究,纳入2022年1月至2023年12月在该院首次确诊并接受规范治疗的160例 NB患儿作为研究对象.通过既往病历及随访记录获取基线资料和2年内的生存结局.根据2年内生存结局将 NB患儿分为死亡组和生存组.比较2组患儿NLR、PLR、SII及基线资料.采用多因素Logistic回归分析NB患儿2年死亡的影响因素,采用受试者工作特征(ROC)曲线分析血细胞衍生指标对NB患儿2年死亡的预测价值.结果 随访2年,160例患儿中41例死亡,119例生存.与生存组比较,死亡组外周血NLR、PLR、SII、中性粒细胞计数(NE)、血小板计数(PLT)及国际神经母细胞瘤分期系统(INSS)为Ⅲ～Ⅳ期的患儿占比升高(P<0.05),淋巴细胞计数(LYM)下降(P<0.05).多因素Logistic回归分析结果显示,INSS分期为Ⅲ～Ⅳ期,以及PLR、NLR、SII升高是NB患儿2年死亡的危险因素(P<0.05).ROC曲线分析结果显示,PLR、NLR、SII单独及3项联合预测NB患儿2年死亡的曲线下面积(AUC)分别为0.752(0.677～0.817)、0.793(0.722～0.853)、0.812(0.799～0.834)、0.960(0.917～0.985),3项联合预测的 AUC 大于 PLR、NLR、SII单独预测的 AUC(Z=3.685、4.378、5.121,均P<0.05).结论 PLR、NLR、SII升高与 NB患儿2年死亡风险增加有关.3项指标联合可提高对NB患儿2年死亡风险的预测效能.
Objective To investigate the associations of blood cell-derived indices[the neutrophil-to-lym-phocyte ratio(NLR),platelet-to-lymphocyte ratio(PLR)and systemic immune-inflammation index(SII)]with the risk of 2-year mortality in children with neuroblastoma(NB).Methods A single-center retrospective cohort study was conducted involving 160 children with NB who were newly diagnosed and received standard-ized treatment at the hospital from January 2022 to December 2023.Baseline data and survival outcomes with-in 2 years were obtained from existing medical records and follow-up records.According to their survival out-comes within 2 years,the NB children were divided into a death group and a survival group.NLR,PLR,SII and baseline characteristics were compared between the two groups.Multivariate Logistic regression analysis was performed to identify influencing factors for 2-year mortality in children with NB.Receiver operating characteristic(ROC)curve analysis was performed to evaluate the predictive value of blood cell-derived indi-ces for 2-year mortality in children with NB.Results During the 2-year follow-up,41 of the 160 children died and 119 survived.Peripheral blood NLR,PLR,SII,neutrophil count(NE),platelet count(PLT)and the pro-portion of NB children with International Neuroblastoma Staging System(INSS)stage Ⅲ-Ⅳ disease were significantly higher in the death group than those in the survival group(P<0.05),whereas the lymphocyte count(LYM)was significantly lower(P<0.05).Multivariate Logistic regression analysis showed that INSS stage Ⅲ-Ⅳ disease and elevated PLR,NLR and SII were risk factors for 2-year mortality in children with NB(P<0.05).ROC curve analysis showed that the areas under the curves(AUCs)of PLR,NLR,and SII indi-vidually and in combination for predicting 2-year mortality in children with NB were 0.752(0.677-0.817),0.793(0.722-0.853),0.812(0.799-0.834)and 0.960(0.917-0.985)respectively.The AUC of the three-index combination was significantly greater than those of PLR,NLR,and SII individually(Z=3.685,4.378,and 5.121,respectively;all P<0.05).Conclusion Elevated PLR,NLR,and SII are associated with an increased risk of 2-year mortality in children with NB.The combination of the three indices improves the pre-dictive performance for 2-year mortality in this population.
鲍文澜;李超;武志祥;蒋马伟
上海交通大学医学院附属新华医院 放疗科,上海 200092上海交通大学医学院附属新华医院 核医学科,上海 200092上海交通大学医学院附属新华医院 小儿外科,上海 200092上海交通大学医学院附属新华医院 放疗科,上海 200092
医药卫生
神经母细胞瘤中性粒细胞与淋巴细胞比值血小板与淋巴细胞比值系统性免疫炎症指数儿童死亡
neuroblastomaneutrophil-to-lymphocyte ratioplatelet-to-lymphocyte ratiosystemic immune-inflammation indexchildrenmortality
《检验医学与临床》 2026 (18)
2449-2453,2461,6
国家自然科学基金项目(82472715).
评论