外周血中性粒细胞-淋巴细胞比值、血小板-淋巴细胞比值对不可切除肝细胞癌经导管动脉化疗栓塞和靶向免疫治疗疗效及预后的预测价值
Prognostic value of peripheral blood neutrophil to lymphocytes ratio and platelet to lymphocyte ratio in the combined treatment of unresectable hepatocellular carcinoma through transcatheter arterial chemoembolization + targeted immunotherapy
江博文 1舒畅 1赵向阳 1陶涛 1谈燚1
作者信息
- 1. 233000 蚌埠医学院第一附属医院肝胆外科
- 折叠
摘要
目的 探讨外周血中性粒细胞-淋巴细胞比值(NLR)、血小板-淋巴细胞比值(PLR)基线值及其动态变化对接受经导管动脉化疗栓塞(TACE)加仑伐替尼及卡瑞利珠单抗治疗的肝细胞癌(HCC)患者疗效及预后的预测价值.方法 回顾性分析 2020年 1月至2023年 2月蚌埠医学院第一附属医院收治的 119 例接受TACE加仑伐替尼及卡瑞利珠单抗三联疗法的HCC患者的临床资料,统计治疗前及治疗2个月时的NLR、PLR值分别记作NLR0、PLR0 和NLR2、PLR2,根据临床疗效评价是否有效将所有患者分为有效组和无效组,比较两组的NLR0、PLR0 和NLR2、PLR2,根据受试者工作特征(ROC)曲线得出NLR、PLR的最佳截断值,将NLR、PLR分成高、低 2 组,进行Kaplan-Meier生存分析,单因素及多因素回归分析采用Cox比例风险模型.结果 根据ROC确定NLR0、PLR0 和NLR2、PLR2 的最佳截断值为2.1、134.4和2.8、153.0.有效组NLR2 和 PLR2 水平均明显低于无效组(均P<0.01).单因素及多因素分析表明,NLR2、PLR0、年龄与总生存期相关(均P<0.05).动态分析发现,低PLR0、低PLR2 组的中位生存期为 29 个月,显著优于高PLR0、高PLR2 组的 14 个月(P<0.001);低NLR0、低NLR2 组的中位生存期为 26.5 个月,优于高NLR0、高NLR2 组的 18.1 个月(P=0.002).结论 外周血NLR、PLR的基线值及动态变化对接受TACE加仑伐替尼及卡瑞利珠单抗的患者疗效及预后均有一定预测价值.
Abstract
Objective To investigate the value of baseline and dynamic changes of peripheral blood neutrophil to lymphocyte ratio(PLR)and platelet to lymphocyte ratio(PLR)in predicting the curative effect and prognosis of patients with hepatocellular carcinoma(HCC)treated with transcatheter arterial chemoembolization(TACE)+ Lenvatinib + camrelizumab.Methods The clinical data of 119 HCC patients admitted to the First Affiliated Hospital of Bengbu Medical College from January 2020 to February 2023 who received triple therapy of TACE + Lenvatinib + camrelizumab were retrospectively analyzed.The levels of NLR and PLR before treatment and two months after treatment were recorded as NLR0,PLR0,NLR2 and PLR2,respectively.The levels of NLR0,PLR0 and NLR2,PLR2 in the effective group and the ineffective group were compared.According to receiver operating characteristic(ROC)curve,the optimal cut-off values of NLR and PLR were obtained,and used as the basis for grouping high and low.Kaplan-Meier method was used for survival analysis,and Cox proportional risk model was used for univariate and multivariate regression analysis.Results According to ROC,the best cut-off points of NLR0,PLR0 and NLR2,PLR2 were 2.10,134.4 and 2.8,153.0.The levels of NLR2 and PLR2 in the effective group were significantly lower than those in the ineffective group(P<0.01).Univariate and multivariate analysis showed that NLR2,PLR0,and age were correlated with overall survival(all P<0.05).Dynamic analysis revealed that the median survival time of the low PLR0 and low PLR2 groups was 29 months,significantly better than the 14 months of the high PLR0 and high PLR2 groups(P<0.001);the median survival time of the low NLR0 and low NLR2 groups was 26.5 months,which was better than the 18.1 months of the high NLR0 and high NLR2 groups(P=0.002).Conclusion The baseline values and dynamic changes of peripheral blood NLR and PLR can predict the efficacy and prognosis of patients receiving TACE + Lenvatinib + Camrelizumab.
关键词
癌,肝细胞/中性粒细胞-淋巴细胞比值/血小板-淋巴细胞比值/疗效/预后/经导管动脉化疗栓塞/仑伐替尼/卡瑞利珠单抗Key words
Carcinoma,hepatocellular/Neutrophil to lymphocytes ratio/Platelet to lymphocyte ratio/Curative effect/Prognosis/Transcatheter arterial chemoembolization/Lenvatinib/Camrelizumab引用本文复制引用
基金项目
安徽省高等学校自然科学研究项目(KJ2018ZD022)
安徽省教育厅高等学校科研项目(2022AH051416)
蚌埠医学院研究生科研创新计划(BYYCX22089)
出版年
2024
NETL
NSTL
万方数据