摘要
目的探讨外周血细胞炎症标志物中性粒细胞与淋巴细胞比值(NLR)、系统免疫炎症指数(SII)对晚期非小细胞肺癌(NSCLC)免疫治疗预后的预测价值。方法回顾性分析2018年1月至2022年6月在安徽省滁州市第一人民医院接受免疫治疗的58例晚期NSCLC患者的血液学及临床资料。通过X-tile软件计算NLR、SII的最佳截断值,根据最佳截断值将患者分别分为高、低两个组别。分析不同NLR、SII水平与临床病理特征、临床疗效、预后的关系,采用Cox回归模型对影响患者预后的因素进行单因素和多因素分析。结果NLR的最佳截断值为3.2,SII的最佳截断值为546.5。低NLR组(NLR<3.2,n=26)、高NLR组(NLR≥3.2,n=32)患者间区域淋巴结转移(χ^(2)=5.03,P=0.025)、转移部位数(χ^(2)=11.60,P=0.001)差异均有统计学意义;低SII组(SII<546.5,n=28)、高SII组(SII≥546.5,n=30)患者间原发灶位置差异有统计学意义(χ^(2)=8.34,P=0.004)。低NLR组的客观缓解率[50.00%(13/26)]高于高NLR组[21.88%(7/32)],差异有统计学意义(χ^(2)=5.02,P=0.025);低NLR组的疾病控制率[69.23%(18/26)]虽高于高NLR组[50.00%(16/32)],但差异无统计学意义(χ^(2)=2.19,P=0.139)。低SII组的客观缓解率[53.57%(15/28)]高于高SII组[26.67%(8/30)],疾病控制率[67.86%(19/28)]也高于高SII组[33.33%(10/30)],差异均有统计学意义(χ^(2)=4.38,P=0.036;χ^(2)=6.91,P=0.009)。低NLR组患者中位总生存期(OS)(17.6个月)长于高NLR组(11.7个月),差异有统计学意义(χ^(2)=11.07,P=0.001);低SII组患者中位OS(16.5个月)长于高SII组(12.3个月),差异有统计学意义(χ^(2)=5.53,P=0.019)。单因素分析显示,美国东部肿瘤协作组(ECOG)评分(HR=2.20,95%CI为1.10~4.39,P=0.025)、脑转移(HR=3.24,95%CI为1.61~6.50,P=0.001)、转移部位数(HR=2.83,95%CI为1.44~5.57,P=0.003)、NLR(HR=3.22,95%CI为1.56~6.66,P=0.002)和SII(HR=2.18,95%CI为1.12~4.24,P=0.021)均是接受免疫治疗晚期NSCLC患者预后的独立影响因素;多因素分析显示
Objective To explore the predictive value of neutrophil to lymphocyte ratio(NLR)and systemic immune-inflammation index(SII)of inflammatory markers of peripheral blood cells on the prognosis in the advanced non-small cell lung cancer(NSCLC)patients with immune therapy.Methods The hematologic and clinical data of 58 patients with advanced non-small cell lung cancer who received the treatment of immune therapy in the First People′s Hospital of Chuzhou of Anhui Province from January 2018 to June 2022 were retrospectively analyzed.X-tile software was used to calculate the optimal cut-off values of NLR and SII.All patients were divided into high and low groups according to the optimal cut-off values.The relationship between different NLR,SII and clinicopathological features,clinical efficacy,prognosis of the advanced non-small cell lung cancer patients with immune therapy were analyzed.Cox regression models were used to perform univariate and multivariate analyses of factors affecting patient prognosis.Results The optimal cut-off values for NLR and SII were 3.2 and 546.5,respectively.There were statistically significant differences in regional lymph node metastasis(χ^(2)=5.03,P=0.025)and the number of metastatic sites(χ^(2)=11.60,P=0.001)between patients in the low-NLR group(NLR<3.2,n=26)and the high-NLR group(NLR≥3.2,n=32).There were statistically significant differences in location of the primary site(χ^(2)=8.34,P=0.004)between patients in the low-SII group(SII<546.5,n=28)and the high-SII group(SII≥546.5,n=30).The objective response rate(ORR)of the low-NLR group[50.00%(13/26)]was higher than that of the high-NLR group[21.88%(7/32)],and there was a statistically significant difference(χ^(2)=5.02,P=0.025);the disease control rate(DCR)of the low-NLR group[69.23%(18/26)]was higher than that of the high-NLR group[50.00%(16/32)],but there was no statistically significant difference(χ^(2)=2.19,P=0.139).The ORR of the low-SII group[53.57%(15/28)]was higher than that of the high-SII group[26.67%(8/30)];The DCR of t
作者
何广思
王军
冯蒙蒙
He Guangsi;Wang Jun;Feng Mengmeng(Second Department of Oncology,First People's Hospital of Chuzhou of Anhui Province,Chuzhou 239001,China)
出处
《国际肿瘤学杂志》
CAS
2023年第6期321-327,共7页
Journal of International Oncology
基金
滁州市科技计划(2022ZD011)。
关键词
癌
非小细胞肺
治疗
预后
系统免疫炎症指数
中性粒细胞与淋巴细胞比值
Carcinoma,non-small-cell lung
Therapy
Prognosis
Systemic immune-inflammation index
Neutrophil to lymphocyte ratio
