The Clinical Significance Of NLR And MLR In Malignant Tumor Patients With Acute Pulmonary Embolism

Objective: To explore the clinical significance of neutrophil to lymphocyte ratio(NLR),monocyte to lymphocyte ratio(MLR)in malignant tumor patients with acute pulmonary embolism(APE),in order to make blood tests as accurate quantitative tools which can be used to evaluate the malignant tumor patients' risk of APE and the severity of the disease,prognosis.Methods: Analyse the date of patients with malignant tumors who was diagnosed and treated in our hospital from January 2009 to December 2017.According to the inclusion and exclusion criteria,solid tumor patients with clear pathological diagnosis and complete clinical data were selected as the research subjects.According to whether APE occurred within 2 years after the diagnosis of tumor,all patients were divided into APE group and non APE group.The two groups were matched by 1:1 according to tumor type.The clinical features and blood test indexes of the two groups were collected and analyzed statistically.Results: A total of 208 patients with malignant tumor were included in the study.There was no significant difference in age,sex,BMI and smoking history between APE group and non APE group.Patients in APE group had more complications and later stage(P < 0.05).In APE group,white blood cell count,neutrophil count,lymphocyte count,hemoglobin level,hematocrit,red blood cell distribution width,MLR and NLR increased significantly,albumin and low density lipoprotein levels were significantly decreased(P < 0.05).High NLR level was an independent risk factor for APE in patients with malignant tumor(OR=1.207,95%CI:1.409 ~ 1.386,P < 0.05).Fiting NLR ? 2.25,MLR ?0.26 respect into the classical Khorana score model can optimization the model(AUC:0.773 + 0.033 VS 0.721 + 0.035,0.762 + 0.032 VS 0.721 + 0.035,P < 0.05).Patient who had a high NLR level(NLR ? 2.25,)at the time of tumor diagnosis is more susceptible to get APE in 60 days(P < 0.05).If patient got a high NLR level(NLR ? 2.25,)at the time of APE diagnosis,he is suggested to have higher s PESI score,heavier thrombus burden,and more serious condition(P <0.05).The independent risk factors for NLR rise were D-dimer 500ng/ml(OR=15.188,95%CI:1.843 to 125.17,P < 0.05),PLR level(OR=1.016,95%CI:1.001 to 1.032,P < 0.05),and white blood cell count(OR=1.016,range 1.671 to 1.671).Conclusion: NLR is an independent risk factor for APE in malignant tumor patients,and can be used to assess the severity of APE.MLR and NLR can be used to optimize Khorana risk assessment model.