Objective: To investigate whether platelet to lymphocyte ratio (PLR) in peripheral blood and body mass index (BMI) can be independent prognostic factors in patients with melanoma. Methods: Clinical date of 140 patients with melanoma in the Affiliated Cancer Hospital of Zhengzhou University and Henan Cancer Hospital from January 1, 2010 to December 31, 2015 were analyzed retrospectively.Receiver operating characteristic (ROC) curve was performed the optimal cut-off value for PLR.The 140 patients were divided into high PLR group and low PLR group.According to "Guidelines for prevention and control of overweight and obesity in Chinese adults" , the patients were divided into high BMI group and low BMI group.The relationship between PLR, BMI with overall survival (OS), progression free survival (PFS) and disease free survival (DFS) were analyzed.The Kaplan-Meier method and Log rank test was used for univariate survival analysis and Cox proportional hazards regression model for multivariate analysis. Results: The optimal cut-off value of PLR determined by ROC curve was PLR=120.15, and BMI threshold was 24.Univariate survival analysis showed that PLR, BMI and clinical stage were the factors affecting the OS in patients (P<0.05). The median survival time (MST) was 21 months in the whole group and 17 months in the high PLR group, 34 months in the low PLR group, respectively; the MST in the high and low BMI group were 29 months and 13 months, respectively.The difference was statistically significant (P<0.05). The effects of PLR and BMI on PFS and DFS were not statistically significant.Cox multivariate analysis showed that PLR, BMI and clinical stage were independent prognostic factors of OS (P<0.05). And BMI was the only independent protective factor for OS, the risk of death decreased by 0.611 times, with each unit increased for BMI.Clinical subgroup analysis showed that PLR also was risk factor to the prognosis of patients with stage Ⅱ, Ⅲ, and Ⅳ (P<0.05). Conclusions: PLR is an independent prognostic risk factor for patients with melanoma, and BMI is an independent protective factor.PLR and BMI are important factors in prognostic evaluation of melanoma.
目的： 探讨外周血血小板与淋巴细胞比值(PLR)、体质指数(BMI)与黑色素瘤患者预后的关系。 方法： 回顾分析郑州大学附属肿瘤医院2010年1月1日至2015年12月31日收治的140例黑色素瘤患者的临床资料。采用受试者工作特征曲线(ROC)确定PLR最佳cut－off值，根据cut－off值分别分为高PLR组、低PLR组。根据《中国成人超重和肥胖症预防控制指南》分为高BMI组、低BMI组。分析PLR、BMI与患者总生存期(OS)、无进展生存时间(PFS)、无病生存期(DFS)的相关性，单因素生存分析采用Kaplan－Meier法和log rank检验，多因素分析采用Cox比例风险回归模型。 结果： ROC曲线确定的PLR最佳cut－off值为PLR＝120.15，BMI临界值为24 kg/m(2)。单因素生存分析表明，PLR、BMI、临床分期均为影响患者OS的因素(P<0.05)，全组患者中位生存期(MST)为21个月，高、低PLR组MST分别为17、34个月；高、低BMI组MST分别为29、13个月，差异均有统计学意义(均P<0.05)。而PLR、BMI对患者PFS、DFS的影响均无统计学意义。Cox多因素分析表明，PLR、BMI、临床分期为影响患者OS的独立因素(P<0.05)。而且BMI是一个保护性因素，BMI每增加1个单位患者死亡风险下降0.611倍。临床分期亚组分析表明，PLR对Ⅱ、Ⅲ、Ⅳ期患者预后均为危险因素(P<0.05)。 结论： PLR为影响黑色素瘤患者OS的独立危险因素，BMI为影响患者OS的独立保护性因素，高PLR提示预后相对较差、高BMI提示预后相对好，二者对黑色瘤患者生存期判断具有重要价值。.
Keywords: Body mass index; Melanoma; Platelet to lymphocyte ratio; Prognosis.