单核细胞与淋巴细胞比值对神经胶质瘤临床预后及异柠檬酸脱氢酶基因1突变的影响

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摘要目的探讨单核细胞与淋巴细胞比值（MLR）对胶质瘤患者临床预后的影响及与异柠檬酸脱氢酶基因1（IDH1）突变的关系。方法回顾性分析2006年8月～2015年11月于我院脑外科行手术治疗的80例神经胶质瘤患者的资料。MLR最佳临床分界值采用ROC曲线确定，最佳临床分界值为0.21，并依此分为MLR＜0.21组（n=37）和MLR≥0.21组（n=43）。术后生存情况考察采用Kaplan-Meier和Log-Rank法，临床预后因素采用COX比例风险模型来分析，IDH1突变应用免疫组织化学方法进行检测。结果MLR是神经胶质瘤的独立预后因素。MLR＜0.21组的术后中位生存时间（Overall survival，OS）为57.07个月；MLR≥0.21组的术后中位OS为48.73个月，两组的术后中位OS比较，差异有统计学意义（P＜0.05）。IDH1发生突变的MLR＜0.21组患者的中位OS明显长于MLR≥0.21组及IDH1未发生突变患者，差异有统计学意义（P＜0.05）。结论MLR具有简单实用、非侵袭性、可重复性强等特点，对神经胶质瘤患者的预后有较好的预测作用。

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	张立志
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关键词 ：单核细胞与淋巴细胞比值, 神经胶质瘤, 异柠檬酸脱氢酶基因1, 预后, 总生存时间

Abstract：ObjectiveTo investigate the potential prognostic significance of monocyte to lymphocyte ratio(MLR)in patients with glioma and its relationship with isocitrate dehydrogenase 1　(IDH1)mutation.MethodsData of 80 patients with glioma who underwent surgery in our hospital from August 2006 to November 2015 were retrospectively analyzed.The receiver operating characteristic curve　(ROC)was used to evaluate the optimal cutoff value of MLR,and based on the optimal cutoff value,which was 0.21,to divide into MLR＜0.21 group(n=37)and MLR≥0.21 group(n=43).The survival time was analyzed by Kaplan-Meier and Log-Rank methods.The Cox′s proportional hazards regression model was used to evaluate the independent prognostic factors,and used the immunohistochemistry method to detect the IDH1 mutation.ResultsMLR was the independent prognostic factors in glioma.The postoperative median overall survival(OS)of patients with MLR＜0.21 group was 57.07 months,and the median OS of patients with MLR≥0.21 group was 48.73 months.The difference of postoperative median OS between the two groups was statistically significant(P＜0.05).The median OS of patients with MLR＜0.21 with IDH1 mutation was significantly longer than that of patients with MLR≥0.21 and IDH1 without mutation,the differences were statistically significant(P＜0.05).ConclusionMLR is simple and convenient,noninvasive,reproducible,and it is a good predictor of prognosis in patients with glioma.

Key words： Monocyte to lymphocyte ratio Glioma Isocitrate dehydrogenase 1 Prognosis Overall survival

通讯作者: 张志文（1960-），男，吉林延边人，博士，主任医师，研究方向：神经肿瘤

作者简介: 张立志（1980-），男，湖北钟祥人，本科，主治医师，研究方向：颅脑创伤、肿瘤及神经介入

引用本文:

张立志;刘平;吉慧军;李守春;张志文. 单核细胞与淋巴细胞比值对神经胶质瘤临床预后及异柠檬酸脱氢酶基因1突变的影响[J]. 中国当代医药, 2018, 25(18): 21-25.
ZHANG Li-zhi;LIU Ping;JI Hui-jun;LI Shou-chun;ZHANG Zhi-wen. Monocyte to lymphocyte ratio in patients with glioma and its relationship with isocitrate dehydrogenase 1 mutation. 中国当代医药, 2018, 25(18): 21-25.

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