外周血LMR、MPVLR对晚期恶性肿瘤患者TFA-IRAEs的预测效能  

Efficacy of peripheral blood LMR and MPVLR in predicting TFA⁃IRAEs in cases with advanced malignant tumors

作　　者：黎敏 苏也 乌齐阳 LI Min;SU Ye;WU Qiyang(Department of Oncology,Guangde People’s Hospital,Guangde,Anhui,China,242200)

机构地区：[1]广德市人民医院肿瘤科,安徽广德242200

出　　处：《分子诊断与治疗杂志》2024年第7期1363-1367,共5页Journal of Molecular Diagnostics and Therapy

基　　金：安徽省重点研究与开发计划项目(20190407020064)。

摘　　要：目的 探讨淋巴细胞/单核细胞比值(LMR)、平均血小板体积/淋巴细胞比值(MPVLR)对晚期恶性肿瘤患者免疫治疗相关甲状腺不良事件(TFA-IRAE)的预测效能。方法 选择2020年1月至2022年12月于广德市人民医院接受PD-1/PD-L1抑制剂治疗的110例晚期恶性肿瘤患者为研究对象,根据有无TFA-IRAE发生分为TFA-IRAE组(61例)与无TFA-IRAE组(49例)。检测并对比两组外周血LMR、MPVLR。采用受试者工作特性(ROC)曲线分析LMR、MPVLR对晚期恶性肿瘤患者发生TFA-IRAE的预测价值。采用二分类Logistic逐步回归分析探讨晚期恶性肿瘤患者发生TFA-IRAE的影响因素。结果 TFA-IRAE组患者LMR低于无TFA-IRAE组患者、MPVLR明显高于无TFA-IRAE组患者,差异有统计学意义(均P<0.05)。LMR、MPVLR预测晚期恶性肿瘤患者发生TFA-IRAE的AUC(95%CI)分别为0.829(0.784~0.879)、0.756(0.711~0.806),两者联合预测的AUC(95%CI)为0.914(0.870~0.963)。两组TNM分期、基础疾病(高血压、糖尿病、冠心病、慢性阻塞性肺疾病)、吸烟史、饮酒史、免疫治疗线数比较差异无统计学意义(均P>0.05)。TFA-IRAE组患者女性、年龄≥60岁比例高于无TFA-IRAE组患者,差异有统计学意义(均P<0.05)。多因素Logistic逐步回归分析显示:女性(OR=2.394,95%CI:1.227~4.671)、LMR≤3.73(OR=3.294,95%CI:1.639~6.618)、MPVLR≥5.23(OR=4.693,95%CI:1.985~11.094)是晚期恶性肿瘤患者发生TFA-IRAE的影响因素(均P<0.05)。结论 低LMR、高MPVLR与晚期恶性肿瘤患者发生TFA-IRAE有关,两者能作为预测晚期恶性肿瘤患者发生TFA-IRAE的实验室指标。Objective To investigate the predictive efficacy of lymphocyte/monocyte ratio(LMR)and mean platelet volume/lymphocyte ratio(MPVLR)in immunotherapy-related adverse thyroid events(TFA-IRAEs)in cases with advanced malignant tumors.Methods A total of 110 cases with advanced malignant tumors who received PD-1/PD-L1 inhibitors at Guangde People’s Hospital from January 2020 to De-cember 2022 were selected.They were divided into two groups:the TFA-IRAE group(61 cases)and the non-TFA-IRAE group(49 cases)based on the presence or absence of TFA-IRAE.Peripheral blood LMR and MPVLR were detected and compared between the two groups.The predictive value of LMR and MPVLR for TFA-IRAE in patients with advanced malignant tumors was analyzed using ROC analysis.The influencing fac-tors of TFA-IRAE in cases with advanced malignant tumors were explored through Binary Logistic stepwise re-gression analysis.Results The LMR in the TFA-IRAE group was lower than that in the non-TFA-IRAE group,while the MPVLR in the TFA-IRAE group was higher than that in the non-TFA-IRAE group(P<0.05).The AUC(95%CI)of LMR and MPVLR for predicting TFA-IRAE in cases with advanced malignant tumors was 0.829(0.784~0.879)and 0.756(0.711~0.806),respectively.The AUC(95%CI)of combined prediction was 0.914(0.870~0.963).There was no significant difference in TNM stage,underlying diseases(hypertension,diabetes,coronary heart disease,chronic obstructive pulmonary disease),smoking history,drinking history,and immunotherapy line number between the two groups(P>0.05).The proportion of females and individuals aged≥60 years in the TFA-IRAE group was higher than that in the non-TFA-IRAE group(P<0.05).Female(OR=2.394,95%CI:1.227~4.671),LMR≤3.73(OR=3.294,95%CI:1.639~6.618),MPVLR≥5.23(OR=4.693,95%CI:1.985-11.094)were the influencing factors of TFA-IRAE in patients with advanced malignant tumors(P<0.05).Conclusion Low LMR and high MPVLR are associated with TFA-IRAE in patients with advanced malignant tumors.These markers can be used as laboratory indicators to pre-dict T

关 键 词：晚期恶性肿瘤 免疫检查点抑制剂 淋巴细胞/单核细胞比值 平均血小板体积/淋巴细胞比值 甲状腺功能异常-免疫相关不良反应 

分 类 号：R730.43[医药卫生—肿瘤]