中性粒细胞/淋巴细胞比值对晚期肺癌免疫检查点抑制剂相关性肺炎的预测价值  

Predictive value of neutrophil to lymphocyte ratio in immune checkpoint inhibitor-related pneumonitis in lung cancer

作　　者：韩利会 田辉[1] 杨秋安[1] HAN Lihui;TIAN Hui;YANG Qiu′an(Department of Radiation Oncology,Qilu Hospital of Shandong University,Shandong Province,Ji′nan 250012,China)

机构地区：[1]山东大学齐鲁医院肿瘤放疗科,山东济南250012

出　　处：《中国当代医药》2022年第20期20-25,共6页China Modern Medicine

摘　　要：目的探讨外周血淋巴细胞亚群及炎症相关指标在晚期肺癌免疫检查点抑制剂相关性肺炎(CIP)发生中的预测价值。方法回顾性分析2019年2月至2021年11月山东大学齐鲁医院行PD-1/PD-L1抑制剂治疗且行淋巴细胞亚群检测的77例晚期肺癌患者的临床资料。根据是否发生CIP,将其分为CIP组(11例)和非CIP组(66例)。比较两组患者的淋巴细胞亚群水平、中性粒细胞/淋巴细胞比值(NLR)、淋巴细胞/单核细胞比值(LMR)和血小板/淋巴细胞比值(PLR)的差异,并采用ROC曲线评估各指标对CIP发生的预测价值。结果随访期间,11例患者发生了CIP,发生率14.3%。CIP组患者的基线NLR高于非CIP组,差异有统计学意义(P<0.05);但两组患者的淋巴细胞亚群水平、LMR和PLR比较,差异无统计学意义(P>0.05)。ROC曲线显示,NLR对CIP预测的AUC为0.718(95%CI:0.502~0.933),截断值为4.50,敏感度为75.8%,特异度为72.7%。结论晚期肺癌患者免疫治疗前NLR可作为CIP预测指标,但淋巴细胞亚群、LMR和PLR与CIP的发生无明显相关。Objective To investigate the predictive value of peripheral blood lymphocyte subsets and inflammation related indexes in the occurrence of immune checkpoint inhibitor associated pneumonia(CIP)in advanced lung cancer.Methods A retrospective analysis was performed on the clinical data of 77 patients with advanced lung cancer who received PD-1/PD-L1 inhibitor treatment and lymphocyte subsets detection in Qilu Hospital of Shandong University from February 2019 to November 2021.According to the occurrence of CIP,they were divided into CIP group(11 cases)and non-CIP group(66 cases).The levels of lymphocyte subsets,neutrophil to lymphocyte ratio(NLR),lymphocyte to monocyte ratio(LMR)and platelet/lymphocyte ratio(PLR)were compared between two groups,and the predictive value of each indicator for CIP occurrence was evaluated by ROC curve.Results During follow-up,CIP occurred in 11 patients,the incidence of 14.3%.The baseline NLR in CIP group was higher than that in non-CIP group,and the difference was statistically significant(P<0.05).However,there were no significant differences in lymphocyte subsets,LMR and PLR between two groups(P>0.05).ROC curve showed that the AUC predicted by NLR for CIP was 0.718(95%CI:0.502-0.933),the cut-off value was 4.50,the sensitivity was 75.8%,and the specificity was 72.7%.Conclusion NLR can be used as a predictor of CIP in advanced lung cancer patients before immunotherapy,but lymphocyte subsets,LMR and PLR have no significant correlation with CIP occurrence.

关 键 词：肺癌 中性粒细胞/淋巴细胞比值 淋巴细胞亚群 PD-1/PD-L1抑制剂 免疫检查点抑制剂相关性肺炎 

分 类 号：R734.2[医药卫生—肿瘤]