首页|血清炎性标志物与一线免疫抑制剂治疗晚期非小细胞肺癌患者预后的关系

血清炎性标志物与一线免疫抑制剂治疗晚期非小细胞肺癌患者预后的关系

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目的 探讨基线水平中性粒细胞-淋巴细胞比值(NLR)、血小板计数-淋巴细胞比值(PLR)、单核细胞-淋巴细胞比值(MLR)、泛免疫炎症值(PIV)在应用 PD-1 抑制剂联合化疗的晚期非小细胞肺癌(Non-small cell lung cancer,NSCLC)中的预测价值,并建立预后相关的列线图模型.方法 回顾性分析 2019 年 1 月—2021 年 1 月于哈尔滨医科大学附属肿瘤医院一线应用PD-1 抑制剂联合化疗的 77 例驱动基因阴性的晚期NSCLC患者的临床资料.采用单因素及多因素Cox回归分析确定无进展生存期(Progression-free survival,PFS)的独立预后因素;建立预后相关的列线图模型,并通过一致性指数等评估模型预测的准确性.结果 多因素Cox回归分析表明,MLR、PIV、脑转移、胸膜转移是驱动基因阴性的晚期NSCLC患者PFS的独立影响因素(P<0.05).根据Cox回归结果构建的列线图预后模型预测能力较好(C-index值为0.786,95%CI:0.721～0.851).ROC曲线表明MLR与PIV联合检测无进展生存期预后的效果(AUC=0.717,P=0.001)优于MLR(AUC=0.643)、PIV(AUC=0.640).结论 MLR、PIV、脑转移、胸膜转移可预测一线应用化疗联合PD-1 抑制剂治疗的驱动基因阴性的晚期NSCLC患者的预后,建立的列线图模型具有较高的准确度和临床实用性.MLR与PIV联合检测的预测效能可能优于MLR、PIV单独检测.
Relationship between serum inflammatory markers and prognosis of advanced non-small cell lung cancer patients treated with first-line immunosuppressants
Objective The aim of this study was to explore the application of baseline neutrophil-lymphocyte ratio(NLR),platelet count-lymphocyte ratio(PLR),monocyte-lymphocyte ratio(MLR),and pan-immune inflammation value(PIV)in the use of PD-1 inhibitors combined with chemotherapy in advanced non-small cell lung cancer(NSCLC),and establish a prognosis-related nomogram model.Methods The clinical data of 77 patients with driver gene-negative advanced NSCLC who received first-line PD-1 inhibitor combined with chemotherapy at Harbin Medical University Cancer Hospital from January 2019 to January 2021 were retro-spectively analyzed.Univariate and multivariate Cox regression analysis were used to determine the independent prognostic factors of progression-free survival(PFS);A prognostic-related nomogram model was established,and the accuracy of prediction model was e-valuated through consistency index.Results Multivariate Cox regression analyses showed that MLR,PIV,brain metastasis,and pleu-ral metastasis were independent factors affecting PFS in patients with driver gene-negative advanced NSCLC(P<0.05).The nomo-gram prognostic model constructed based on the Cox regression results had a good predictive ability(C-index value was 0.786,95%CI:0.721-0.851).The ROC curve showed that the combined effect of MLR and PIV in detecting the prognosis of PFS(AUC=0.717,P=0.001)was better than that of MLR(AUC=0.643)and PIV(AUC=0.640).Conclusion MLR,PIV,brain metastasis,and pleural metastasis can predict the prognosis of driver gene-negative advanced NSCLC patients treated with first-line chemothera-py combined with PD-1 inhibitors.The established nomogram model has high accuracy and clinical practicability.The predictive per-formance of combined detection of MLR and PIV may be better than that of separate detection of MLR and PIV.

Non-small cell lung cancerNeutrophil-lymphocyte ratioPlatelet count-lymphocyte ratioMonocyte-lympho-cyte ratioPan-immune inflammatory disease value

张萱、李欣、赵康

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哈尔滨医科大学附属肿瘤医院肿瘤内科(哈尔滨 150081)

非小细胞肺癌 中性粒细胞-淋巴细胞比值 血小板计数-淋巴细胞比值 单核细胞-淋巴细胞比值 泛免疫炎症值

哈尔滨医科大学附属肿瘤医院海燕基金北京医学奖励基金会项目黑龙江省卫生健康委科研项目

JJMS2021-18YXJL-2020-1191-023720230303020283

2024

10.11904/j.issn.1002-3070.2024.01.006

实用肿瘤学杂志
黑龙江省,辽宁省,吉林省肿瘤防治办公室

实用肿瘤学杂志

CSTPCD
影响因子：0.528
ISSN：1002-3070
年,卷(期)：2024.38(1)
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