Study on the Relationship between Serum PNI,LMR,ALB/GLB and Treatment Efficacy and Prognosis of Elderly Patients with Non-Small Cell Lung Cancer
Objective:To investigate the relationship between serum prognostic nutritional index(PNI),lymphocyte/monocyte ra-tio(LMR),albumin/globulin ratio(ALB/GLB)and treatment efficacy and prognosis in elderly patients with non-small cell lung cancer(NSCLC).Methods:A total of 143 elderly patients with NSCLC who were treated with programmed death receptor-1(PD-1)inhibitors in our hospital from January 2021 to January 2023 were retrospectively analyzed.Serum PNI,LMR and ALB/GLB were detected before treatment.According to the mean values of PNI,LMR and ALB/GLB,the patients were divided into low PNI group and high PNI group,low LMR group and high LMR group,low ALB/GLB group and high ALB/GLB group.According to the efficacy,they were divided into disease control(DC)and objective remission(OR),and the differences in efficacy of different PNI,LMR and ALB/GLB levels were compared.The elderly patients with NSCLC were divided into survival group and death group according to the follow-up results.Uni-variate and multivariate COX regression analysis were used to analyze the factors affecting the prognosis of elderly patients with NSCLC.The receiver operating characteristic(ROC)curve was used to analyze the value of PNI,LMR and ALB/GLB in predicting poor prognosis of elderly patients with NSCLC.Results:The DC rate and OR rate of low PNI group,low LMR group and low ALB/GLB group were lower than those of high PNI group,high LMR group and high ALB/GLB group(P＜0.05).Distant metastasis,low PNI,low LMR and low ALB/GLB were risk factors for poor prognosis in elderly patients with NSCLC(P＜0.05).The area under the curve(AUC)of PNI,LMR and ALB/GLB in predicting poor prognosis of elderly NSCLC patients were 0.792,0.839 and 0.800,respectively.The AUC of combined prediction was 0.931,which was higher than that of single index prediction.Conclusion:Low levels of PNI,LMR and ALB/GLB are as-sociated with poor treatment efficacy and poor prognosis of PD-1 inhibitors in elderly NSCLC patients.Combined PNI,LMR and ALB/GLB can effectively predict the risk of poor prognosis in elderly NSCLC patients.
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