Liu Shuai, Zhao Liuyuan, Zhou Guohua
Department of Anesthesiology, Affiliated Drum Tower Hospital, Medical School of Nanjing University, Nanjing, China.
Department of Pain Medicine, Harbin Medical University Cancer Hospital, Harbin, China.
Front Genet. 2022 Oct 20;13:1016085. doi: 10.3389/fgene.2022.1016085. eCollection 2022.
This study aims to investigate the prognostic impact of peripheral blood markers in patients with advanced non-small cell lung cancer (NSCLC) undergoing immunotherapy. In the current multicenter study, 157 advanced NSCLC cases treated by immunotherapy at three institutions were included. Biochemical parameters in baseline peripheral blood were collected. The associations between biochemical parameters and prognosis were investigated by the Kaplan-Meier survival analyses and Cox regression, and the predictive performances of biomarkers were evaluated receiver operating characteristic analysis. The neutrophil-to-lymphocyte ratio (NLR) (progression-free survival [PFS]: hazard ratio [HR], 1.766; 95% confidence interval [CI], 1.311-2.380; < 0.001; overall survival [OS]: HR, 1.283; 95% CI, 1.120-1.469; < 0.001) and red blood cell distribution width (RDW) (PFS: HR, 1.052; 95% CI, 1.005-1.102; = 0.031; OS: HR, 1.044; 95% CI, 1.001-1.091; = 0.042) were revealed as independent predictors for both PFS and OS. In addition, NLR ≥3.79 (1-year PFS, 24.2% [95% CI, 15.2%-38.4%] 27.3% [95% CI, 18.2%-41.1%], = 0.041; 1-year OS, 44.2% [95% CI, 32.5%-60.1%] 71.8% [95% CI, 60.6%-85.2%], < 0.001) or RDW ≥44.8 g/L (1-year PFS, 19.2% [95% CI, 11.4%-32.3%] 31.7% [95% CI, 21.9%-46.0%], = 0.049; 1-year OS, 54.0% [95% CI, 42.7%-68.3%] 63.1% [95% CI, 50.6%-78.6%], = 0.014) was significantly correlated to poorer PFS and OS than NLR < 3.79 or RDW <44.8 g/L. Moreover, NLR and RDW achieved areas under the curve with 0.651 (95% CI, 0.559-0.743) and 0.626 (95% CI, 0.520-0.732) for predicting PFS, and 0.660 (95% CI, 0.567-0.754) and 0.645 (95% CI, 0.552-0.739), for OS. Therefore, PLR and RDW could help predict the immunotherapeutic efficacy of advanced NSCLC.
本研究旨在探讨外周血标志物对接受免疫治疗的晚期非小细胞肺癌（NSCLC）患者预后的影响。在当前的多中心研究中，纳入了在三个机构接受免疫治疗的157例晚期NSCLC病例。收集了基线外周血中的生化参数。通过Kaplan-Meier生存分析和Cox回归研究生化参数与预后之间的关联，并通过受试者工作特征分析评估生物标志物的预测性能。中性粒细胞与淋巴细胞比值（NLR）（无进展生存期[PFS]：风险比[HR]，1.766；95%置信区间[CI]，1.311 - 2.380；P < 0.001；总生存期[OS]：HR，1.283；95% CI，1.120 - 1.469；P < 0.001）和红细胞分布宽度（RDW）（PFS：HR，1.052；95% CI，1.005 - 1.102；P = 0.031；OS：HR，1.044；95% CI，1.001 - 1.091；P = 0.042）被揭示为PFS和OS的独立预测因子。此外，NLR≥3.79（1年PFS，24.2%[95% CI，15.2% - 38.4%]对27.3%[95% CI，18.2% - 41.1%]，P = 0.041；1年OS，44.2%[95% CI，32.5% - 60.1%]对71.8%[95% CI，60.6% - 85.2%]，P < 0.001）或RDW≥44.8 g/L（1年PFS，19.2%[95% CI，11.4% - 32.3%]对31.7%[95% CI，21.9% - 46.0%]，P = 0.049；1年OS，54.0%[95% CI，42.7% - 68.3%]对63.1%[95% CI，50.6% - 78.6%]，P = 0.014）与NLR < 3.79或RDW < 44.8 g/L相比，与更差的PFS和OS显著相关。此外，NLR和RDW预测PFS的曲线下面积分别为0.651（95% CI，0.559 - 0.743）和0.626（95% CI，0.520 - 0.732），预测OS的曲线下面积分别为0.660（95% CI，0.567 - 0.754）和0.645（95% CI，0.552 - 0.739）。因此，PLR和RDW有助于预测晚期NSCLC的免疫治疗疗效。
