He Qiong, Li Yamin, Zhou Xihong, Zhou Wen, Xia Chunfang, Zhang Ruzhe, Zhang Zhengjie, Hu Aiyang, Peng Siyin, Li Jing
Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital, Central South University, Changsha, Hunan Province, China.
Department of Oncology, The Second Xiangya Hospital, Central South University, Changsha, Hunan Province, China.
J Int Med Res. 2021 Apr;49(4):3000605211004021. doi: 10.1177/03000605211004021.
This study aimed to identify a predictive marker of response to epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) in patients with EGFR-mutant advanced lung adenocarcinoma.
A cohort of 190 patients with EGFR-mutant advanced lung adenocarcinoma was analyzed. Receiver operating characteristic curve analysis was used to evaluate the optimal cutoffs for fibrinogen levels, the neutrophil-to-lymphocyte ratio (NLR), and the platelet-to-lymphocyte ratio (PLR) for predicting progression-free survival (PFS). Univariate and multivariate survival analyses were performed to identify factors correlated with PFS and overall survival (OS).
High NLR was associated with worse performance status. In univariate analysis, fibrinogen levels, NLR, and PLR were correlated with OS and PFS. In multivariate analysis, all three variables remained predictive of OS, whereas only fibrinogen levels and PLR were independent prognostic factors for PFS. Furthermore, the combination of fibrinogen levels and PLR (F-PLR score) could stratify patients into three groups with significantly different prognoses, and the score was independently predictive of survival.
The F-PLR score predicted the prognosis of patients with EGFR-mutant advanced lung adenocarcinoma who received EGFR-TKIs, and this score may serve as a convenient blood-based marker for identifying high-risk patients.
本研究旨在确定表皮生长因子受体酪氨酸激酶抑制剂（EGFR-TKIs）治疗的EGFR突变型晚期肺腺癌患者疗效的预测标志物。
分析了190例EGFR突变型晚期肺腺癌患者的队列。采用受试者工作特征曲线分析来评估纤维蛋白原水平、中性粒细胞与淋巴细胞比值（NLR）和血小板与淋巴细胞比值（PLR）预测无进展生存期（PFS）的最佳临界值。进行单因素和多因素生存分析以确定与PFS和总生存期（OS）相关的因素。
高NLR与更差的体能状态相关。在单因素分析中，纤维蛋白原水平、NLR和PLR与OS和PFS相关。在多因素分析中，所有这三个变量仍然是OS的预测因素，而只有纤维蛋白原水平和PLR是PFS的独立预后因素。此外，纤维蛋白原水平和PLR的组合（F-PLR评分）可将患者分为三组，预后有显著差异，且该评分可独立预测生存。
F-PLR评分可预测接受EGFR-TKIs治疗的EGFR突变型晚期肺腺癌患者的预后，该评分可作为一种方便的基于血液的标志物来识别高危患者。
