首页|外周血LMR、MPVLR对晚期恶性肿瘤患者TFA-IRAEs的预测效能

外周血LMR、MPVLR对晚期恶性肿瘤患者TFA-IRAEs的预测效能

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

Advanced malignant tumorImmune checkpoint inhibitorsLymphocyte/monocyte ratioMean platelet volume/lymphocyte ratioThyroid dysfunction-immune-related adverse reactions

黎敏、苏也、乌齐阳

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广德市人民医院肿瘤科,安徽,广德 242200

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

安徽省重点研发计划

20190407020064

2024

分子诊断与治疗杂志
中山大学

分子诊断与治疗杂志

CSTPCD
影响因子：0.65
ISSN：1674-6929
年,卷(期)：2024.16(7)