Xu Cong, Yao Xiaojun, Li Ting, Wang Jue, An Bo, Wang Jing, Sui Xinbing, Leung Elaine Lai-Han, Wu Qibiao
State Key Laboratory of Quality Research in Chinese Medicine, Macau University of Science and Technology, Avenida Wai Long, Taipa, Macau 999078, China.
Faculty of Chinese Medicine, Macau University of Science and Technology, Avenida Wai Long, Taipa, Macau 999078, China.
Transl Cancer Res. 2020 Apr;9(4):2875-2883. doi: 10.21037/tcr.2020.02.28.
Neutrophil-lymphocyte ratio (NLR) has been reported as a prognostic biomarker in various cancers, but its prognostic value for advanced epidermal growth factor receptor (EGFR) mutation-positive non-small cell lung cancer (NSCLC) treated with EGFR tyrosine kinase inhibitors (TKIs) remains unclear. To address this issue, we performed a retrospective study to investigate the clinical value of NLR in these patients.
All data were collected from medical records. Sixty-five cases with stage IIIB-IVB EGFR-mutant NSCLC treated with EGFR-TKIs were enrolled. The pretreatment NLR was analyzed for associations with disease control rate (DCR) and progression-free survival (PFS). The primary outcomes of interest were DCR and PFS. All the data were analyzed using SPSS 23.0. The PFS curves were plotted by Kaplan-Meier analysis and log-rank test. Univariate and multivariate Cox regression analyses were used to determine the factors affecting PFS.
The results indicated that, compared with those with lower NLR (<2.57), the patients with a higher NLR (≥2.57) showed a significantly shorter PFS (8.8 . 12.2 months, P<0.01), and decreased DCR by the end of 8, 10 months after TKIs treatment (62.5% . 93.3%, P=0.014; 38.5% . 77.8%, P=0.037). COX multivariate analysis showed that NLR was an independent prognostic factor for PFS (P<0.001).
Elevated NLR is significantly associated with lower DCR, shorter PFS, and might act as a meaningful biomarker for predicting the efficacy of TKIs treatment and the prognosis of advanced EGFR-mutant NSCLC. High-quality prospective clinical trials with longer follow-up are needed to further confirm the results.
中性粒细胞与淋巴细胞比值（NLR）已被报道为多种癌症的预后生物标志物，但其对接受表皮生长因子受体（EGFR）酪氨酸激酶抑制剂（TKIs）治疗的晚期EGFR突变阳性非小细胞肺癌（NSCLC）的预后价值仍不清楚。为解决这一问题，我们进行了一项回顾性研究，以探讨NLR在这些患者中的临床价值。
所有数据均从病历中收集。纳入65例接受EGFR-TKIs治疗的IIIB-IVB期EGFR突变NSCLC患者。分析治疗前NLR与疾病控制率（DCR）和无进展生存期（PFS）的相关性。主要关注的结局指标为DCR和PFS。所有数据均使用SPSS 23.0进行分析。采用Kaplan-Meier分析和对数秩检验绘制PFS曲线。采用单因素和多因素Cox回归分析确定影响PFS的因素。
结果表明，与NLR较低（<2.57）的患者相比，NLR较高（≥2.57）的患者PFS显著缩短（8.8对12.2个月，P<0.01），并且在TKIs治疗8、10个月时DCR降低（62.5%对93.3%，P=0.014；38.5%对77.8%，P=0.037）。COX多因素分析显示NLR是PFS的独立预后因素（P<0.001）。
NLR升高与较低的DCR、较短的PFS显著相关，可能是预测TKIs治疗疗效和晚期EGFR突变NSCLC预后的有意义生物标志物。需要进行更长随访时间的高质量前瞻性临床试验来进一步证实这些结果。
