NLR和PLR动态变化预测PD-1/PD-L1治疗晚期非小细胞肺癌患者疗效及预后的价值  

Predictive value of dynamic changes of NLR and PLR on the efficacy and prognosis of patients with advanced non-small cell lung cancer receiving anti PD-1/PD-L1 treatment

作　　者：唐高燕 刘琰 张青云 李娜[1] 于国华[1] TANG Gaoyan;LIU Yan;ZHANG Qingyun;LI Na;YU Guohua(Department of Oncology,Weifang People's Hospital,Shandong Weifang 261041,China)

机构地区：[1]潍坊市人民医院肿瘤内科,山东潍坊261041

出　　处：《现代肿瘤医学》2023年第12期2247-2254,共8页Journal of Modern Oncology

基　　金：潍坊市卫生健康委员会科研基金资助项目(编号:WFWSJK-2022-109)。

摘　　要：目的:探讨中性粒细胞-淋巴细胞比值(NLR)和血小板-淋巴细胞比值(PLR)在晚期非小细胞肺癌(aNSCLC)患者治疗前后的有效性及其对免疫应答的动态变化。方法:回顾性分析2018年1月至2019年5月在我院接受免疫治疗的60例aNSCLC患者。统计患者治疗前后NLR和PLR水平,分别记作NLR_(0)、PLR_(0)以及NLR_(12)、PLR_(12),分析NLR、PLR及其动态变化对晚期NSCLC患者预后的价值。结果:在所有接受免疫治疗的aNSCLC患者中,47例患者治疗有效,无论是在基线还是治疗12周后,有效组的NLR和PLR水平均显著低于无效组;在多因素分析中,无论NLR_(0)水平如何,NLR_(12)高的患者无进展生存期(PFS)和总生存期(OS)较差,PLR的结果与NLR相似。结论:NLR_(12)在预测患者免疫疗效及预后的价值高于NLR_(0),而NLR和PLR的动态变化可能更有助于预测aNSCLC患者的预后。Objective:To investigate the usefulness of neutrophil-to-lymphocyte ratio(NLR)and platelet-to-lymphocyte ratio(PLR)at baseline and 12 weeks after treatment and their dynamic changes for immuneresponse in advanced non-small-cell lung cancer(aNSCLC)patients.Methods:We retrospectively analyzed 60 patients with aNSCLC who received immunotherapy in our hospital from January 2018 to May 2019.The NLR and PLR were assessed at baseline(NLR_(0) and PLR_(0))and 12 weeks after treatment(NLR_(12) and PLR_(12)).Changes in NLR and PLR were obtained by subtracting the initial value from the value obtained at 12 weeks after treatment.Results:In all aNSCLC patients on immunotherapy,47(78.3%)cases were in the response group.Whether at baseline or 12 weeks after treatment,the levels of NLR and PLR in the response group were both significantly lower than those in the non-response group(P<0.05).Patients with a high NLR_(12) had poor progression-free survival(PFS)and overall survival(OS)independently in multivariate analysis.Patients with high NLR_(0)-high NLR_(12) were associated with poor PFS and OS(P=0.009,P=0.001 respectively).Results were similar for PLR.Conclusion:NLR at 12 weeks after treatment appears to be a more accurate biomarker than NLR at baseline.In addition,considering dynamic changes of NLR and PLR during immunotherapy might help to predict a more accurate prognosis in aNSCLC patients.

关 键 词：NLR PLR NSCLC 免疫治疗 预后 

分 类 号：R734.2[医药卫生—肿瘤]