外周血炎症指标对晚期非小细胞肺癌免疫治疗疗效的预测价值  

Predictive value of peripheral blood inflammatory markers on immunotherapy efficacy in advanced non-small cell lung cancer

作　　者：蒋微 池传珍 王伟[1] 张倩[1] JIANG Wei;CHI Chuanzhen;WANG Wei(Department of Respiratory Medicine,Nanjing Chest Hospital,Respiratory Medicine Department of Thoracic Hospital,Affiliated Nanjing Brain Hospital of Nanjing Medical University,Nanjing,Jiangsu 210029,China)

机构地区：[1]江苏省南京市胸科医院呼吸内科、南京医科大学附属脑科医院胸科院区呼吸内科,210029

出　　处：《河北医药》2024年第18期2853-2857,共5页Hebei Medical Journal

基　　金：国家自然科学基金青年科学基金项目(编号:81700068)。

摘　　要：目的探讨外周血炎症指标对晚期非小细胞肺癌(NSCLC)免疫治疗疗效和预后的预测价值。方法回顾性分析2020年1月至2022年6月接受免疫治疗的晚期NSCLC患者107例,收集患者免疫治疗前的中性粒细胞和淋巴细胞比值(NLR)和血小板与淋巴细胞比值(PLR),根据ROC曲线确定NLR和PLR的最佳临界值,分析NLR和PLR对晚期NSCLC患者免疫治疗近期疗效和远期疗效的影响。结果ROC曲线分析显示NLR最佳截断值为3.825,PLR最佳截断值为179;近期疗效分析表明高NLR水平组患者DCR显著低于低NLR水平组(54.3%vs 83.3%,P=0.001),高PLR水平组患者DCR亦显著低于低PLR水平组(59.0%vs 82.4%,P=0.008),但2组患者ORR差异无统计学意义(P>0.05)。Kaplan-Meier生存分析显示,低NLR水平组患者中位PFS高于高NLR水平组(11.0个月vs 6.0个月,P=0.014),低PLR水平组患者中位PFS高于高PLR水平组(11.0个月vs 6.0个月,P=0.034);低NLR水平组患者中位OS高于低NLR水平组(11.0个月vs 8.0个月,P=0.032),低PLR水平组患者中位OS高于高PLR水平组(12.0个月vs 11.0个月,P=0.045)。结论晚期NSCLC免疫治疗中,低基线水平NLR和PLR对患者免疫治疗的疗效和预后呈正相关,是预测晚期NSCLC患者免疫治疗的重要标志物。Objective To investigate the predictive value of peripheral blood inflammatory markers on immunotherapy efficacy and prognosis in advanced non-small cell lung cancer(NSCLC).Methods In this retrospective study,totally 107 patients with advanced NSCLC received immunotherapy in our hospital from January 2020 to June 2022 were enrolled.The neutrophil-to-lymphocyte ratio(NLR)and platelet-to-lymphocyte ratio(PLR)were collected before immunotherapy,and the optimal cut-off values of NLR and PLR were determined according to the receiver operating characteristic(ROC)curve for verifying the short-term and long-term efficacy of immunotherapy in advanced NSCLC.Results ROC analysis showed that the optimal cut-off value of NLR and PLR was 3.825,and 179,respectively.The short-term efficacy analysis showed that the levels of disease control rate(DCR)in the high NLR group were significantly lower than those of the low NLR group(54.3%vs 83.3%,P=0.001).The levels of DCR in the high PLR group were significantly lower than those of the low PLR group(59.0%vs 82.4%,P=0.008).No differences were observed in objective response rate(ORR)between the two groups.Kaplan-Meier survival curve showed that the median progression-free survival(PFS)(11.0 months vs 6.0 months P=0.014)and overall survival(OS)(11.0 months vs 8.0 months,P=0.032)in the low NLR group were significantly higher than those of the high NLR group.Similarly,the median PFS(11.0 months vs 6.0 months,P=0.034)and OS(12.0 months vs 11.0 months,P=0.045)in the low PLR group were significantly higher than those of the high PLR group.Conclusion Low baseline levels of NLR and PLR are positively correlated with immunotherapy efficacy and prognosis in advanced NSCLC,which are important indicators for predicting immunotherapy efficacy in patients with advanced NSCLC.

关 键 词：非小细胞肺癌 免疫治疗 疗效 NLR PLR 

分 类 号：R734.2[医药卫生—肿瘤]