中性粒细胞与淋巴细胞比值、C-反应蛋白与白蛋白比值对接受PD-1抑制剂治疗晚期非小细胞肺癌患者预后的预测作用  

Predictive role of neutrophil-to-lymphocyte ratio and C-reactive protein-to-albumin ratio in prognosis of patients with advanced non-small cell lung cancer received PD-1 inhibitor therapy

作　　者：方平[1] 王根和[1] 左刚[1] FANG Ping;WANG Gen-he;ZUO Gang(Department of Oncology,Huangshan People′s Hospital,Huangshan,Anhui 245000,China)

机构地区：[1]黄山市人民医院肿瘤内科,安徽黄山245000

出　　处：《临床肺科杂志》2022年第12期1798-1803,共6页Journal of Clinical Pulmonary Medicine

基　　金：吴阶平医学基金(No.320.6750.2020-01-22)。

摘　　要：目的探讨中性粒细胞与淋巴细胞比值(Neutrophil-to-lymphocyte ratio,NLR)、C-反应蛋白与白蛋白比值(C-reactive protein-to-Albumin,CAR)对PD-1抑制剂治疗晚期非小细胞肺癌(non-small cell lung cancer,NSCLC)患者预后的关系。方法收集84例接受PD-1抑制剂治疗的晚期NSCLC患者的临床资料,使用受试者工作曲线特征曲线(ROC曲线)选取最佳截断值将患者资料进行分组。采用Kaplan-Meier生存分析和Log-rank检验比较患者生存情况差异,并使用Cox比例风险模型探究接受PD-1抑制剂治疗晚期NSCLC预后的影响因素。结果NLR、CAR预测接受PD-1抑制剂治疗晚期NSCLC患者PFS曲线下面积为0.819、0.800,P<0.05。单因素分析显示,Ⅳ期、转移部位个数≥3、单药使用、PD-L1表达阴性、NLR>2.41、CAR>0.04的接受PD-1抑制剂治疗晚期NSCLC患者无疾病进展生存期(Progressives Free Survival,PFS)的较短,(P<0.05)。Cox比例风险模型显示,转移部位个数≥3、PD-L1表达阴性、NLR>2.41、CAR>0.04是缩短接受PD-1抑制剂治疗晚期NSCLC患者PFS的独立危险因素(P均<0.05)。结论NLR、CAR结合肿瘤转移部位个数及PD-L1表达对预测接受PD-1抑制剂治疗的晚期NSCLC患者的预后有一定价值,为患者是否接受免疫治疗方案的选择提供参考。。Objective To investigate the predictive effect of neutrophil-to-lymphocyte ratio(NLR)and C-reactive protein-to-Albumin(CAR)ratio on prognosis of patients with advanced non-small cell lung cancer(NSCLC)received PD-1 inhibitor therapy.Methods The clinical data of 84 patients with advanced NSCLC who received PD-1 inhibitor therapy were collected,and the receiver operating curve characteristic curve(ROC curve)was used to select the best cut-off value to group the patient data.Kaplan-Meier survival analysis and Log-rank test were used to compare the differences in survival among patients,and Cox proportional hazards model was used to explore the influencing factors of the prognosis of patients receiving PD-1 inhibitor therapy for advanced NSCLC.Results NLR and CAR predicted the area under the curve of PFS in patients with advanced NSCLC who received PD-1 inhibitor therapy were 0.819 and 0.800(P<0.05).Univariate analysis showed that progression-free survival(PFS)of advanced NSCLC patients received PD-1 inhibitor therapy with stageⅣ,number of metastatic sites≥3,single drug use,negative PD-L1 expression,NLR>2.41,and CAR>0.04 was shorter(P<0.05).Cox proportional hazards model showed that the number of metastatic sites≥3,negative PD-L1 expression,NLR>2.41,and CAR>0.04 were independent factors for shortening PFS in patients with advanced NSCLC received PD-1 inhibitor therapy(all P<0.05).Conclusion NLR,CAR combined with the number of tumor metastatic sites and PD-L1 expression can predict the prognosis of advanced NSCLC patients treated with PD-1 inhibitor.

关 键 词：非小细胞肺癌 预测 PD-1抑制剂 中性粒细胞与淋巴细胞比值 C反应蛋白与白蛋白比值 

分 类 号：R734.2[医药卫生—肿瘤]