老年急性髓系白血病患者外周血NLR、MLR及PLR表达及对预后的预测价值

Expressions of peripheral blood NLR,MLR and PLR in elderly patients with acute myelogenous leukemia and their predictive value for prognosis

中文关键词: 老年  急性髓系白血病  外周血中性粒细胞与淋巴细胞比值  单核细胞与淋巴细胞比值  血小板与淋巴细胞比值  预后

英文关键词: elderly  acute myelogenous leukemia  peripheral blood neutrophil to lymphocyte ratio  monocyte to lym-phocyte ratio  platelet to lymphocyte ratio  prognosis

中文摘要:

      目的 分析老年急性髓系白血病(AML)患者外周血中性粒细胞与淋巴细胞比值(NLR)、单核细胞与淋巴细胞比值(MLR)及血小板与淋巴细胞比值(PLR)表达及对预后的预测价值.方法 回顾性选取2020年1月—2024年6月期间收治的实施去甲基化药物联合维奈托克治疗的老年AML患者102例,随访1年后,根据是否死亡(死亡原因为白血病相关导致)分为生存组(n=75)和死亡组(n=27).检测并比较2组外周血NLR、MLR及PLR表达水平,以Cox回归分析方法分析外周血NLR、MLR及PLR表达水平与AML患者死亡的相关性.以受试者工作曲线(ROC)预测外周血NLR、MLR及PLR表达水平对AML患者预后的预测价值.结果 与生存组比较,死亡组老年AML患者外周血NLR、MLR及PLR表达水平更高(P＜0.05).经 Cox 回归分析模型分析,外周血 NLR[HR(95％CI):5.202(1.937～13.969)]、MLR[HR(95％CI):3.089(1.433～6.661)]及 PLR[HR(95％CI):4.586(1.731～14.127)]表达水平与老年 AML 患者死亡呈正相关(P＜0.05).ROC曲线中,外周血NLR、MLR及PLR表达水平预测老年AML患者预后的曲线下面积(AUC)分别为0.867、0.752、0.826,敏感度分别为 77.78％、81.48％、70.37％,特异度分别为 80.00％、65.33％、85.33％.结论 外周血NLR、MLR及PLR与老年AML患者预后情况可能密切相关,在预测老年AML患者预后中具有潜在价值.

英文摘要:

      Objective To analyze the expressions of the neutrophil to lymphocyte ratio(NLR),monocyte to lympho-cyte ratio(MLR),and platelet to lymphocyte ratio(PLR)in the peripheral blood of elderly patients with acute myeloid leuke-mia(AML)and their predictive value for prognosis.Methods 102 elderly AML patients who were treated with demethylating drugs combined with venetoclax from January 2020 to June 2024 were retrospectively selected.They were followed up for one year,and then divided into survival group(n=75)and death group(n=27)based on whether they died(cause of death:leu-kemia-related).The expression levels of NLR,MLR and PLR in peripheral blood were detected and compared between the two groups.Cox regression analysis was used to analyze the correlation between the expression levels of NLR,MLR and PLR in peripheral blood and the death of AML patients.Receiver operating characteristic curve(ROC)was adopted to assess the pre-dictive value of expression levels of peripheral blood NLR,MLR and PLR for the prognosis of AML patients.Results Com-pared with the survival group,the expression levels of NLR,MLR and PLR in peripheral blood in the death group were signifi-cantly higher(P＜0.05).Cox regression analysis model suggested that the expression levels of peripheral blood NLR[HR(95％CI):5.202(1.937-13.969)],MLR[HR(95％CI):3.089(1.433-6.661)]and PLR[HR(95％CI):4.586(1.731-14.127)]were positively correlated with the death of elderly AML patients(P＜0.05).ROC curve analysis showed that the ar-ea under the ROC curve(AUC)of peripheral blood NLR,MLR and PLR for predicting the prognosis of elderly AML patients was 0.867,0.752 and 0.826,respectively,the sensitivities were 77.78％,81.48％and 70.37％,respectively,and the speci-ficities were 80.00％,65.33％,and 85.33％,respectively.Conclusion Peripheral blood NLR,MLR and PLR may be closely related to the prognosis of elderly AML patients and have potential value in predicting the prognosis of these patients.