Objective To explore the predictive value of neutrophil-to-lymPhocyte ratio(NLR),platelet to-lymphocyte ratio(PLR),carcinoembryonic antigen(CEA),neuron-specific enolase(NSE),cytokeratin 19 fragment 21-1(CYFRA21-1)and other clinicopathological features for efficacy of the two cycles and the opti-mal of immunotherapy of advanced non-small cell lung cancer(NSCLC)patients.Methods The retrospective study was enrolled 162 advanced NSCLC patients who received immunotherapy as a basic treatment in Tangs-han People's Hospital from January 2022 to June 2023.The clinicopathological features,peripheral blood(NLR0 and PLR0 counts,CEA0,NSE0 and CYFRA21-10 levels)within 2 weeks at baseline,and peripheral blood(NLR0 and PLR0 counts,CEA0,NSE0 and CYFRA21-10 levels)within 2 weeks before the second cy-cles of immunotherapy were collected.The two-cycle-efficacy and the optimal efficacy of immunotherapy of advanced NSCLC patients were evaluated according to RECIST 1.1.Chi-square test or Fisher exact test was used to analyze the relationship between the five peripheral blood indexes of two-cycle-efficacy and the optimal efficacy of immunotherapy.Multivariate Logistic regression was implied to analyze the independent influen-cing factors of the two-cycle-efficacy and the optimal efficacy of immunotherapy.Results The age(P=0.024)and pathologic type(P=0.038)were associated with two-cycle-efficacy of the immunotherapy of ad-vanced NSCLC patients.The predicting immunotherapy efficacy of NLR2,PLR2,CEA2,NSE2 and CY-FRA21-12 were superior to predicting immunotherapy efficacy of NLR0,PLR0,CEA0,NSE0,CYFRA21-10,△NLR,△PLR,△CEA,△NSE,and △CYFRA21-1.The predictive ability of series combination with these five indexes(NLR2,PLR2,CEA2,NSE2 and CYFRA21-12)was more effective than each one.Pa-tients of advanced NSCLC with low levels of NLR2(＜2.56),PLR2(＜148.53),CEA2(＜2.65ng/ml),NSE2(＜17.73ng/ml)and CYFRA21-12(＜2.68ng/ml)showed better response after two cycles of immu-notherapy(P＜0.05),NSCLC patients with low levels of NLR2(＜2.56),PLR2(＜141.93),CEA2(＜21.83ng/ml),NSE2(＜10.00ng/ml)and CYFRA21-12(＜2.99ng/ml)had the best immunotherapy re-sponse(P＜0.05).Multivariate Logistic regression analysis showed that age(OR=3.490,95％CI:1.419-8.584,P=0.007),PLR2(OR=0.346,95％CI:0.141-0.845,P=0.020)and CYFRA21-12(OR=0.305,95％CI:0.119-0.779,P=0.013)were independent influencing factors of immunotherapy two-cycle-efficacy of advanced NSCLC patients.PLR2(OR=0.314,95％CI:0.149-0.660,P=0.002),CEA2(OR=0.330,95％CI:0.112-0.972,P=0.044)and CYFRA21-12(OR=0.410,95％CI:0.189-0.887,P=0.024)were independent influencing factors of immunotherapy the optimal efficacy of advanced NSCLC patients.The ad-vanced NSCLC patients with the higher level of PD-L1 expression had a higher objective response rate(ORR)after immunotherapy.Conclusion Patients with advanced NSCLC,younger than 65 years old or with squa-mous cell carcinoma,could benefit from immunotherapy.Advanced NSCLC patients with low levels of NLR2,PLR2,CEA2,NSE2 and CYFRA21-12 were more likely to benefit from immunotherapy.NLR2,PLR2,CEA2,NSE2 and CYFRA21-12 have potential in predicting the efficacy of immunotherapy in ad-vanced NSCLC patients,the series combination of these five indexes(NLR2,PLR2,CEA2,NSE2 and CY-FRA21-12)have better predictive efficacy.Age,PLR2 and CYFRA21-12 are independent influencing factors of immunotherapy two-cycle-efficacy of advanced NSCLC patients.PLR2,CEA2 and CYFRA21-12 are inde-pendent influencing factors of immunotherapy the optimal efficacy of advanced NSCLC patients.
维普
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