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Objective To explore the predictive value of preoperative inflammatory immune and nutritional indicators[neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), platelet to serum albumin ratio (PAR) and prognostic nutritional index (PNI)] for the prognosis of patients with thymoma. Methods The clinical data of 109 patients with thymoma,admitted in the Department of Thoracic Surgery, the Second Hospital of Lanzhou University from February 2014 to December 2019, were retrospectively analyzed. The relationships of preoperative NLR, PLR, PAR and PNI to patients' overall survival (OS)were analyzed by receiver operating characteristic (ROC) curves, the best cut-off value was calculated and then used for patients grouping. The Kaplan-Meier survival analysis was used to draw the OS and progression-free survival (PFS) curve of thymoma patients and calculate the cumulative survival rate. The influence factors affecting the prognosis of thymoma patients were analyzed with univariate and multivariate Cox proportional hazards regression model. Results Among 109 thymoma patients, there were 57 males (52.3%, 57/109) and 52 females (47.7%, 52/109), the age ranged in 19-84 (51.3±9.9) years, and no perioperative death occurred. The area under the curve (AUC) with NLR, PLR, PAR and PNI to predict the OS of thymoma patients were 0.484 (P=0.832), 0.600 (P=0.181), 0.708 (P=0.005) and 0.693 (P=0.010), respectively. The best cut-off values of PNI and PNI were 5.05 and 51.48, respectively. Compared to the patients with low PAR, the histological types of tumors in patients with high PAR were likely to incline to be type B and type C (72.7% vs. 50.8%, P=0.030), and not easy to be completely resected (27.3% vs. 9.2%,P=0.013). Compared to patients with high PNI, the tumors in patients with low PNI were more likely to invade blood vessels (34.7%vs. 13.3%, P=0.008), and histological types were likely to incline to be type B and type C (69.4% vs. 51.7%, P=0.004), and possessed higher Masaoka stage (47.0% vs. 28.3%, P=0.021). The cumulative OS and cumulative PFS at 12, 36 and 60 months were higher in low PAR group than in high PAR group (P=0.013, P=0.002), and the cumulative OS and cumulative PFS at 12, 36 and 60 months were lower in low PNI group than in high PNI group (P=0.010, P=0.014). Cox univariate analysis showed that vascular invasion,WHO classification, Masaoka stage, complete resection, PAR and PNI were obviously correlated with OS and PFS in patients with thymoma (P>0.05). Multivariate analysis showed that Masaoka stage, complete resection, adjuvant therapy and PNI were the independent prognostic factors of OS in patients with thymoma, and complete resection was the independent prognostic factor of PFS in patients with thymoma (P<0.05). Conclusion Preoperative PAR and PNI are significantly related to the prognosis of patients with thymoma, and may potentially become the new indicators to guide the treatment and evaluating diagnosis of patients with thymoma.
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| 科 Family | 属数 Number of genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) | 属 Genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) |
|---|---|---|---|---|---|---|
| 鹅膏菌科Amanitaceae | 2 | 11 | 5.26 | 鹅膏菌属 Amanita | 10 | 4.78 |
| 小菇科 Mycenaceae | 2 | 12 | 5.74 | 丝盖伞属 Inocybe | 5 | 2.39 |
| 多孔菌科 Polyporaceae | 8 | 14 | 6.70 | 蜡蘑属 Laccaria | 5 | 2.39 |
| 红菇科 Russulaceae | 3 | 23 | 11.00 | 小皮伞属 Marasmius | 6 | 2.87 |
| 小菇属 Mycena | 11 | 5.26 | ||||
| 光柄菇属 Pluteus | 5 | 2.39 | ||||
| 红菇属 Russula | 17 | 8.13 | ||||
| 栓菌属 Trametes | 5 | 2.39 |
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