Background: Anal squamous cell carcinoma (ASCC) is a rare malignancy primarily treated with chemoradiotherapy (CRT). This study evaluated outcomes and the prognostic value of simple hematologic indices in patients receiving modern image-guided CRT. Methods: Fifty-five patients with non-metastatic ASCC treated between 2017 and 2025 were retrospectively analyzed. Survival was estimated by Kaplan–Meier methods, and prognostic factors were assessed by log-rank testing and Cox regression. Baseline neutrophil-to-lymphocyte (NLR) and platelet-to-lymphocyte (PLR) ratios were analyzed individually and in combination with nodal status. Results: At a median follow-up of 53.1 months, overall survival reached 90% at 5 years, whereas disease-free survival declined to 51%. Nodal positivity showed a non-significant trend toward poorer DFS. Baseline PLR ≥ 150 was significantly associated with inferior DFS in univariable analysis (HR 5.28, 95% CI 1.12–24.97,p= 0.036), while NLR ≥ 3 showed a borderline effect (p= 0.108). In multivariable models, PLR retained borderline prognostic relevance (p= 0.083), whereas Kaplan–Meier curves indicated non-significant trends (p= 0.129 and 0.055). Integrated models combining nodal status with PLR ± NLR improved risk discrimination: Model A (N + PLR ≥ 150 ± NLR ≥ 3) showed a trend (p= 0.059), and Model B (N + PLR ≥ 150) reached significance (p= 0.021; C-index ≈ 0.68–0.69). Conclusions: Modern CRT achieved excellent OS with acceptable toxicity, though early recurrences limited DFS. Integrating hematologic indices with nodal status provides a pragmatic, cost-effective approach for individualized risk assessment and follow-up in ASCC.
背景：肛管鳞状细胞癌（ASCC）是一种罕见恶性肿瘤，主要采用放化疗（CRT）治疗。本研究评估了接受现代图像引导CRT治疗患者的预后及简易血液学指标的预测价值。方法：回顾性分析2017年至2025年间接受治疗的55例非转移性ASCC患者。采用Kaplan-Meier法评估生存率，通过时序检验和Cox回归分析预后因素。分别分析基线中性粒细胞-淋巴细胞比值（NLR）和血小板-淋巴细胞比值（PLR），并将其与淋巴结状态结合评估。结果：中位随访53.1个月时，5年总生存率达90%，而无病生存率降至51%。淋巴结阳性显示无病生存率降低的非显著趋势。单变量分析显示基线PLR≥150与较差无病生存率显著相关（HR 5.28，95% CI 1.12–24.97，p=0.036），而NLR≥3呈临界效应（p=0.108）。多变量模型中PLR保持临界预后相关性（p=0.083），Kaplan-Meier曲线显示非显著趋势（p=0.129和0.055）。淋巴结状态与PLR±NLR结合的整合模型改善了风险区分：模型A（淋巴结阳性+PLR≥150±NLR≥3）呈临界趋势（p=0.059），模型B（淋巴结阳性+PLR≥150）达到统计学显著性（p=0.021；C指数≈0.68–0.69）。结论：现代CRT在可接受的毒性范围内实现了优异的总生存率，但早期复发限制了无病生存率。血液学指标与淋巴结状态的结合为ASCC个体化风险评估和随访提供了实用且经济有效的方法。
肿瘤(癌症)患者之家