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The elevated pretreatment platelet-to-lymphocyte ratio predicts poor outcome in nasopharyngeal carcinoma patients

Tumor Biology volume 36, pages 7775–7787 (2015)Cite this article

Abstract

The aim of this study was to evaluate whether the platelet-to-lymphocyte ratio (PLR) could be used to predict the prognosis of patients with nasopharyngeal carcinoma (NPC). Patients (n = 1261) who were diagnosed with nonmetastatic NPC between January 2008 and December 2010 were recruited. The peripheral platelet and lymphocyte counts were retrieved, and the PLR was calculated. Univariate and multivariate Cox proportional hazards analyses were used to assess their association with PLR: overall survival (OS), cancer-specific survival (CSS), and distant metastasis-free survival (DMFS). The elevated PLR, using the third quartile values (153.64) as the optimal cutoff values, was found to be associated with the significant decline in CSS (hazard ratio [HR] 1.83, 95 % confidence interval [CI] 1.27–2.63, P < 0.001), OS (HR 1.81, 95 % CI 1.28–2.56, P < 0.001), and DMFS (HR 1.60, 95 % CI 1.15–2.23, P = 0.005) that remained significant during the multivariable analyses (CCS HR 1.84, 95 % CI 1.26–2.67, P < 0.001; OS HR 1.83, 95 % CI 1.28–2.61, P < 0.001; DMFS HR 1.56, 95 % CI 1.11–2.19, P = 0.011). Subgroup analyses indicated that the PLR could be used to stratify prognosis effectively for patients with early- or advanced-stage NPC, and Epstein–Barr virus DNA levels of ≥1500 copies/mL. In conclusions, elevated PLR values were associated with poor CSS, OS, and DMFS for patients with NPC; this easily accessed variable based on a large amount of cases multivariate analysis is valuable for predicting prognosis in patients with NPC.

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Acknowledgments

This work was supported by grants from the Program for Sun Yat-Sen University Clinical Research 5010 Program (No.201310), New Century Excellent Talents in University (NCET-12-0562), and Guangdong Provincial Natural Science Foundation of China (S2013020012726) (to M.Y. Chen).

Conflicts of interest

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Affiliations

  1. Department of Nasopharyngeal Carcinoma, Sun Yat-sen University Cancer Center, 651 Dongfeng East Road, Guangzhou, 510060, China

    Rou Jiang, Xiong Zou, Wen Hu, Yu-Ying Fan, Meng-Xia Zhang, Rui You, Rui Sun, Dong-Hua Luo, Qiu-Yan Chen, Pei-Yu Huang, Yi-Jun Hua, Ling Guo & Ming-Yuan Chen

  2. Department of Cancer Prevention, Sun Yat-sen University Cancer Center, 651 Dongfeng East Road, Guangzhou, 510060, China

    Rou Jiang & Yue Yan

  3. Collaborative Innovation Center of Cancer Medicine, State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, 651 Dongfeng East Road, Guangzhou, 510060, China

    Rou Jiang, Xiong Zou, Wen Hu, Yu-Ying Fan, Yue Yan, Meng-Xia Zhang, Rui You, Rui Sun, Dong-Hua Luo, Qiu-Yan Chen, Pei-Yu Huang, Yi-Jun Hua, Ling Guo & Ming-Yuan Chen

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  1. Rou Jiang
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  2. Xiong Zou
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  3. Wen Hu
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Correspondence to Ming-Yuan Chen.

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Rou Jiang and Xiong Zou contributed equally to this work.

Appendix

Appendix

Fig. 6
figure 6

PLR values in control versus nasopharyngeal carcinoma patients

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Fig. 7
figure 7

Kaplan–Meier survival analysis of baseline PLR in NPC patients by quartiles. a Cancer-specific survival curves for PLR; b overall survival curves for PLR; c distant metastasis-free survival curves for PLR

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Table 4 The correlations between PLR and different clinicopathological factors
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Table 5 Prognostic value of PLR for OS, CCS, and DMFS by quartiles
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Table 6 Multivariate Cox proportional hazards regression analysis
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Jiang, R., Zou, X., Hu, W. et al. The elevated pretreatment platelet-to-lymphocyte ratio predicts poor outcome in nasopharyngeal carcinoma patients. Tumor Biol. 36, 7775–7787 (2015). https://doi.org/10.1007/s13277-015-3505-0

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  • DOI: https://doi.org/10.1007/s13277-015-3505-0

Keywords

  • Nasopharyngeal carcinoma
  • Platelet-to-lymphocyte ratio
  • Overall survival
  • Cancer-specific survival
  • Distant metastasis-free survival
  • Prognosis