The Predictive Effect of Systemic Immune-nutrition-inflammation Indexes on PD-1 Immunotherapy for Non-small Cell Lung Cancer
Objective To analyze the effect of systemic immune-nutrition-inflammation indexes[neutrophil-lymphocyte ratio(NLR)and prognostic nutritional index(PNI)]in predicting programmed cell death l(PD-1)immunotherapy for non-small cell lung cancer.Methods A total of 138 patients with non-small cell lung cancer(NSCLC)treated with navuzumab,97 patients with benign pulmonary nodules,and 94 healthy volunteers were selected for the study.The levels of NLR,PNI,white blood cells,neutrophils,lymphocytes,albumin(ALB),and carcinoembryonic antigen(CEA)were compared among the three groups.Cox regression model was used to analyze the independent influencing factors of poor prognosis in NSCLC patients;Spearman correlation was used to analyze the relationship between TNM stage,NLR,CEA,and PNI;the receiver operator characteristic curve(ROC)was used to assess the predictive value of TNM stage,NLR,CEA,and PNI on poor prognosis in NSCLC patients.Results The levels of white blood cells,neutrophils,lymphocytes,NLR,ALB and CEA in NSCLC patients were significantly higher than those in patients with benign pulmonary nodules and healthy volunteers(P＜0.05),whereas the levels of PNI were significantly lower than those in patients with benign pulmonary nodules and healthy volunteers(P＜0.05).The NLR(OR=1.156,95％CI=1.026-1.303),PNI(OR=0.976,95％CI=0.955-0.996),CEA(OR=1.001,95％CI=1.000-1.001)and TNM(OR=2.531,95％CI=1.205-5.317)were the independent influencing factors for poor prognosis of NSCLC patients receiving navuzumab(P＜0.05).Spearman correlation analysis showed that TNM staging was positively correlated with NLR and CEA(r=0.284,0.597,P＜0.001)and negatively correlated with PNI(r=-0.167,P＜0.05);NLR was positively correlated with CEA(r=0.209,P＜0.05)and negatively correlated with PNI(r=-0.693,P＜0.01).The ROC curves showed that the prognostic AUC values of NLR,PNI,CEA,TNM staging and combined tests for NSCLC patients treated with navuzumab were 0.840(95％CI=0.773-0.907),0.611(95％CI=0.512-0.711),0.662(95％CI=0.570-0.754),0.835(95％CI=0.769-0.901),and 0.884(95％CI=0.824-0.944),respectively.Conclusions NLR,PNI can be used as simple,inexpensive and effective biomarkers for assessing poor prognosis in patients with NSCLC treated with nabumab,which can help clinicians to identify high-risk patients who require close monitoring.
neutrophil-lymphocyte ratioprognostic nutritional indexprogrammed cell death 1non-small cell lung cancerprognosisnavuzumab
万方数据
维普
