Department of Respiratory and Critical Care Medicine, Zhuji Affiliated Hospital of Shaoxing University, No.9 Jianmin Road, Taozhu Street, 311800, Zhuji City, Shaoxing, Zhejiang, China.
Wien Klin Wochenschr. 2022 Oct;134(19-20):705-711. doi: 10.1007/s00508-022-02049-4. Epub 2022 Jul 6.
To investigate the prognostic assessment of inflammatory factor serum C‑reactive protein CRP and neutrophil to lymphocyte ratio NLR value in patients with non-small cell lung cancer NSCLC.
A retrospective analysis was conducted for 475 patients with NSCLC who visited our hospital with complete follow-up data from January 2017 to 1 January 2019. The changes of serum CRP, NLR levels in patients with NSCLC of different stages, as well as the changes in the levels of the two indexes before and after chemotherapy in patients with advanced stage were compared using t tests with SPSS19.0 software. Serum CRP and NLR were divided into low and high groups with median intercept values and the relationship between inflammation score index and tumor progression-free survival time (PFS) was analyzed retrospectively. Clinical factors that may affect disease prognosis were included in the proportional hazards (COX) regression model for multifactorial prognostic analysis.
Pretreatment serum levels of NLR and CRP were significantly higher in non-operated patients relative to preoperative levels in surgical patients. Advanced patients had higher levels of both indexes than locally advanced patients. After chemotherapy, the levels of the two indexes reaching remission were significantly lower than those before chemotherapy. The levels of the two indexes in patients with stable disease after chemotherapy were not statistically significant compared with those before chemotherapy, and the levels of the two indexes in the group with progressive disease after chemotherapy were significantly higher than those before chemotherapy. The results of PFS survival analyses showed that PFS was prolonged in the low score CRP and the low score NLR group, compared with the high score group. Multifactorial prognostic analysis showed that smoking, CRP and NLR were risk factors for PFS prognosis in patients with NSCLC.
Serum CRP and NLR are effective predictors of poor prognosis in patients with NSCLC.
探讨炎症因子血清 C-反应蛋白（CRP）和中性粒细胞与淋巴细胞比值（NLR）对非小细胞肺癌（NSCLC）患者的预后评估价值。
回顾性分析了 2017 年 1 月至 2019 年 1 月期间在我院就诊的 475 例 NSCLC 患者的完整随访资料。采用 SPSS19.0 软件中的 t 检验比较不同分期 NSCLC 患者的血清 CRP、NLR 水平变化，以及晚期患者化疗前后两指标水平变化。采用中位数截点值将血清 CRP 和 NLR 分为低和高组，回顾性分析炎症评分指数与肿瘤无进展生存时间（PFS）的关系。将可能影响疾病预后的临床因素纳入比例风险（COX）回归模型进行多因素预后分析。
未手术患者的治疗前血清 NLR 和 CRP 水平明显高于手术患者的术前水平。晚期患者的两项指标水平均高于局部晚期患者。化疗后，达到缓解的两项指标水平明显低于化疗前。化疗后病情稳定的两组患者的两项指标水平与化疗前相比无统计学意义，化疗后病情进展的两组患者的两项指标水平明显高于化疗前。PFS 生存分析结果表明，低 CRP 评分和低 NLR 评分组的 PFS 延长，与高评分组相比。多因素预后分析显示，吸烟、CRP 和 NLR 是 NSCLC 患者 PFS 预后的危险因素。
血清 CRP 和 NLR 是 NSCLC 患者预后不良的有效预测指标。
