中性粒细胞与淋巴细胞比值（NLR）可预测转移性胃癌患者接受 PD-1 抑制剂治疗的生存情况。
Neutrophil-to-Lymphocyte Ratio (NLR) Predicts PD-1 Inhibitor Survival in Patients with Metastatic Gastric Cancer.
机构信息
Medical Oncology Department, The First Medical Center, Chinese PLA General Hospital, Fuxing Road 28, Haidian District, Beijing, China 100853.
Medical Oncology Department, The Second Medical Center, Chinese PLA General Hospital, Fuxing Road 28, Haidian District, Beijing, China 100853.
出版信息
J Immunol Res. 2021 Dec 28;2021:2549295. doi: 10.1155/2021/2549295. eCollection 2021.
BACKGROUND AND AIMS
Biomarkers for systemic inflammation have been introduced into clinical practice for risk-rating in cancer patients' treatment. This study is aimed at confirming the prognostic role of the neutrophil-to-lymphocyte ratio (NLR) as an effective biomarker for patients with metastatic gastric cancer (MGC) receiving anti-PD-1 agents.
METHOD
Patients with MGC who received anti-PD-1 treatment at the Chinese PLA General Hospital between January 2016 and November 2020 were reviewed. The study analyzed the association of NLR and overall survival (OS) or progression-free survival (PFS) and antitumor response rate with PD-1 inhibitors.
RESULTS
137 patients were included in the final analysis. The area under the curve value of NLR for 6-month OS was 0.71. The best cut-off value for NLR was 3.23. NLR < 3.23 was associated with longer OS (HR = 0.38, 95% CI, 0.26-0.57, < 0.001) and PFS (HR = 0.42, 95% CI, 0.29-0.62, < 0.001) in patients with MGC. No significant difference was observed in the objective response rate (ORR) (35.8% vs. 28.6%, = 0.377) and disease control rate (DCR) (86.4% vs. 78.6%, = 0.229) in the NLR < 3.23 group and in the NLR ≥ 3.23 group, respectively. Univariate analysis and multivariate analysis found that NLR was an independent prognosis biomarker for PFS and OS.
CONCLUSIONS
Pretreatment elevated NLR was significantly associated with inferior PFS and OS in patients with MGC who received anti-PD-1 inhibitors. Clinicians need to consider patients with elevated NLR for decisions on immunotherapy strategy.
背景与目的
用于癌症患者治疗风险评估的全身性炎症生物标志物已被引入临床实践。本研究旨在证实中性粒细胞与淋巴细胞比值（NLR）作为转移性胃癌（MGC）患者接受抗 PD-1 药物治疗的有效生物标志物的预后作用。
方法
回顾性分析 2016 年 1 月至 2020 年 11 月在中国人民解放军总医院接受抗 PD-1 治疗的 MGC 患者。本研究分析 NLR 与总生存期（OS）或无进展生存期（PFS）和抗 PD-1 抑制剂的抗肿瘤反应率的相关性。
结果
最终分析纳入 137 例患者。NLR 预测 6 个月 OS 的曲线下面积值为 0.71。NLR 的最佳截断值为 3.23。NLR<3.23 与较长的 OS（HR=0.38，95%CI，0.26-0.57，<0.001）和 PFS（HR=0.42，95%CI，0.29-0.62，<0.001）相关。NLR<3.23 组和 NLR≥3.23 组的客观缓解率（ORR）（35.8%vs.28.6%，=0.377）和疾病控制率（DCR）（86.4%vs.78.6%，=0.229）无显著差异。单因素分析和多因素分析均发现 NLR 是 PFS 和 OS 的独立预后生物标志物。
结论
接受抗 PD-1 抑制剂治疗的 MGC 患者，治疗前 NLR 升高与 PFS 和 OS 降低显著相关。临床医生需要考虑 NLR 升高的患者，以便制定免疫治疗策略。
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