Asociación del índice neutrófilos/linfocitos con la supervivencia en cáncer de cérvix uterino localmente avanzado y metastásico: estudio retrospectivo
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Derechos de autor 2025 Edison Alberto Carrasco-Rubio, Henry Marcel Caballero Narváez
Esta obra está bajo una licencia internacional Creative Commons Atribución-NoComercial-CompartirIgual 4.0.
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https://doi.org/10.33821/778Palabras clave:
cáncer de cérvix uterino, linfocitos, neutrófilos, supervivencia, índiceResumen
Introducción: El cáncer de cérvix uterino es uno de los tumores ginecológicos con mayor mortalidad. La inflamación desempeña un papel clave en su iniciación y progresión metastásica. El índice neutrófilo/linfocitos refleja el equilibrio entre el tumor y la respuesta inmunológica antitumoral, por lo que se ha propuesto como un factor pronóstico relevante. Dada la alta mortalidad de este cáncer, evaluarlo permite estratificar adecuadamente a los pacientes, lo que facilita personalizar el tratamiento y, en consecuencia, optimiza los recursos y costos en salud. Materiales y métodos: Se llevó a cabo un estudio observacional y descriptivo de cohortes históricas en el Hospital Oncológico de SOLCA, núcleo Quito. Participaron pacientes con diagnóstico de cáncer de cérvix localmente avanzado (IB2-IVA) y metastásico (IVB) desde enero del 2010 hasta enero del 2018. Los datos fueron anonimizados según las normativas legales vigentes y actualizadas. Resultados: La población de estudio incluyó a 672 pacientes con un seguimiento de 180 meses y se evaluó el índice neutrófilo/linfocitos antes del tratamiento. Los valores menores a 2,5 se asociaron con un mayor tiempo de sobrevida global y una recurrencia tardía, con datos de 37 meses (IC 95 % de26,3-47,6; p < 0,05) y 30 meses (IC 95 % de 9,4-50,5; p < 0,05), respectivamente. Además, un índice neutrófilo/linfocitos ? 2,5 es un factor que predice la recurrencia. La razón de riesgos (Hazard ratio, HR) para la mortalidad es de 3,09 (IC95% de 2,42 a 3,94; p< 0,05) y para la recurrencia, HR = 3,16 (IC 95 % de 2,47 a 4,05; p < 0,05). Igualmente, los criterios de Moore, en el grupo de riesgo intermedio-alto, HR mortalidad 5,39 y HR recurrencia 10,66, ambos p 0,000. Conclusiones: Un índice neutrófilo/linfocitos menor a 2,5 está relacionado con una mejor sobrevida global y menor tiempo de recurrencia; un índice neutrófilo/linfocitos ? 2,5 está relacionado con un comportamiento tumoral más agresivo con tendencia a la recurrencia temprana y mayor mortalidad.
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