文章：

中性粒细胞与淋巴细胞比值和伴与不伴骨髓增殖性肿瘤者的全因死亡率——一项丹麦纵向研究

Neutrophil-to-lymphocyte ratio and all-cause mortality with and without myeloproliferative neoplasms—a Danish longitudinal study

原文发布日期：2024-02-09

DOI: 10.1038/s41408-024-00994-z

类型: Article

开放获取: 是

英文摘要：

The neutrophil-to-lymphocyte ratio(NLR) is increased in chronic inflammation and myeloproliferative neoplasms (MPN). We hypothesize that NLR is associated with all-cause mortality and mortality by comorbidity burden in the general population and individuals with MPN. We included 835,430 individuals from The Danish General Suburban Population Study, general practitioners, and outpatient clinics. We investigated NLR on mortality stratified by prevalent and incident MPN, essential thrombocythemia (ET), polycythemia vera (PV), myelofibrosis (MF), comorbidity burden (CCI-score), and the Triple-A risk score using hazard ratio (HR) and 95% confidence interval (95%CI). NLR 1–1.9 was the reference level. During a median follow-up of 11.2 years, 197,802 deaths were recorded. All-cause mortality increased for a stepwise increasing NLR with a HR (95%CI) for NLR ≥ 6 of 2.06(2.03–2.09) for the whole population and 2.93(2.44–3.50) in prevalent MPN. ET, PV, and MF had a HR (95%CI) for NLR ≥ 2 of 2.14(1.71–2.69), 2.19(1.89–2.54), and 2.31(1.91–2.80). Results were similar for incident MPN. Mortality was higher for stepwise increasing NLR and CCI-score(pinteraction < 2×10–16), with a HR for NLR ≥ 6 of 2.23(2.17–2.29), 4.10(4.01–4.20), and 7.69(7.50–7.89), for CCI-score 0, 1–2, or ≥3. The Triple-A risk score demonstrated alignment with NLR. Increasing NLR and comorbidity burden were associated with lower survival in individuals without MPN but were even worse in prevalent and incident MPN, ET, PV, and MF.
 

摘要翻译： 

中性粒细胞与淋巴细胞比值（NLR）在慢性炎症及骨髓增殖性肿瘤（MPN）中会升高。我们提出假设：在普通人群及MPN患者中，NLR与全因死亡率及按共病负担分层的死亡率相关。本研究纳入来自丹麦一般郊区人群研究、全科医生及门诊诊所的835,430名个体。我们依据已有的和新发的MPN、原发性血小板增多症（ET）、真性红细胞增多症（PV）、骨髓纤维化（MF）、共病负担（CCI评分）以及三重A风险评分，通过风险比（HR）和95%置信区间（95%CI）分析了NLR对死亡率的影响，并以NLR 1–1.9作为参照水平。在中位随访11.2年期间，共记录到197,802例死亡。随着NLR逐步升高，全因死亡率相应增加：整体人群中NLR≥6的HR（95%CI）为2.06（2.03–2.09），而在已有MPN人群中为2.93（2.44–3.50）。ET、PV和MF患者在NLR≥2时的HR（95%CI）分别为2.14（1.71–2.69）、2.19（1.89–2.54）和2.31（1.91–2.80）。新发MPN患者的结果与此相似。随着NLR和CCI评分逐步升高，死亡率显著上升（交互作用p值＜2×10^–16）。在CCI评分为0、1–2和≥3的组别中，NLR≥6对应的HR分别为2.23（2.17–2.29）、4.10（4.01–4.20）和7.69（7.50–7.89）。三重A风险评分显示与NLR具有一致性。升高的NLR和共病负担与无MPN个体的较低生存率相关，而在已有或新发的MPN、ET、PV及MF患者中，这一关联更为显著。

原文链接：

Neutrophil-to-lymphocyte ratio and all-cause mortality with and without myeloproliferative neoplasms—a Danish longitudinal study