初探肺癌免疫预后指数预测Ⅳ期肺鳞状细胞癌患者免疫治疗疗效和预后  

Preliminary study on the lung immune prognostic index in predicting the efficacy and prognosis of immunotherapy in patients with stageⅣlung squamous cell carcinoma

作　　者：伍妮 周玲 吴旭 胡诗宇 刘一逸 刘新福 WU Ni;ZHOU Ling;WU Xu;HU Shiyu;LIU Yiyi;LIU Xinfu(Department of Oncology,Shaoyang Hospital Affiliated to Nanhua University,Shaoyang 422000,China)

机构地区：[1]南华大学附属邵阳医院肿瘤科,湖南邵阳422000

出　　处：《邵阳学院学报(自然科学版)》2025年第2期100-106,共7页Journal of Shaoyang University:Natural Science Edition

基　　金：邵阳市科技局科研项目(2020NS40)。

摘　　要：目的探究肺癌免疫预后指数(lung immune prognostic index,LIPI)与Ⅳ期肺鳞状细胞癌(lung squamous cell carcinoma,LUSC)患者临床病理特征的相关性及其对免疫检查点抑制剂(immune checkpoint inhibitors,ICIs)疗效及其预后的影响。方法回顾性分析邵阳市中心医院收治的101例自2020年1月至2022年12月应用ICIs的LUSC患者的临床资料。根据洐生中性粒细胞与淋巴细胞比值(derived neutrophil-to-lymphocyte ratio,dNLR)≥3或乳酸脱氢酶(lactate dehydrogenase,LDH)≥245 IU/L两个因素,将患者分为三组,即LIPI评分良好组(n=33)、LIPI评分中等组(n=44)、LIPI评分差组(n=24)。统计分析三组客观缓解率(objective response rate,ORR)、疾病控制率(disease control rate,DCR)、无进展生存期(progression free survival,PFS)、总生存期(overall survival,OS)评估疗效及预后。生存分析采用Kaplan-Meier方法,分析各组临床特征与PFS、OS之间的关系(采用单因素和多因素Cox回归)。结果三组患者ORR、DCR比较,差异无统计学意义(P>0.05)。LIPI评分良好、中等、差组患者的中位PFS分别为7.6、6.4、5.5个月,OS分别为19.3、17.3、12.7个月,差异有统计学意义(P<0.05);Cox回归多因素分析显示,LIPI评分、组织学分级是LUSC患者PFS独立危险因素,LIPI评分是LUSC患者OS独立危险因素(P<0.05)。结论ICIs治疗LUSC患者预后与LIPI评分存在一定相关性,LIPI评分差患者预后差。Objective To evaluate the correlation between the lung immune prognostic index(LIPI)and the clinicopathological characteristics of stageⅣlung squamous cell carcinoma(LUSC)patients,as well as the effect of LIPI on the efficacy and prognosis of immune checkpoint inhibitors(ICIs).Methods A retrospective analysis was conducted on clinical data from 101 LUSC patients treated with ICIs at The Central Hospital of Shaoyang between January 2020 and December 2022.Patients were stratified into three groups based on the derived neutrophil-to-lymphocyte ratio(dNLR)≥3 or lactate dehydrogenase(LDH)≥245 IU/L:good LIPI(n=33),moderate LIPI(n=44),and poor LIPI(n=24).Efficacy was assessed through objective remission rate(ORR),disease control rate(DCR),progression-free survival(PFS),and overall survival(OS)using Kaplan-Meier methods and Cox regression analysis.Results No significant differences were found in ORR and DCR among groups(P>0.05).However,the median PFS was 7.6 months for the good LIPI group,6.4 months for the moderate group,and 5.5 months for the poor group.Median OS was 19.3 months,17.3 months,and 12.7 months,respectively,with these differences being statistically significant(P<0.05).Cox regression confirmed that LIPI score and histologic grading were independent risk factors for PFS and that LIPI score independently predicted OS(P<0.05).Conclusion This study established a correlation between LIPI scores and prognosis in LUSC patients treated with ICIs,indicating that lower LIPI scores are associated with poorer clinical outcomes.

关 键 词：肺鳞状细胞癌 临床病理特征 肺癌免疫预后指数 免疫检查点抑制剂 疗效 预后 

分 类 号：R734.2[医药卫生—肿瘤]