Academic Unit of Surgery, University of Glasgow, Glasgow, UK.
Department of Oncology, Beatson West of Scotland Cancer Centre, Glasgow, UK.
Cancer Med. 2024 Aug;13(16):e70139. doi: 10.1002/cam4.70139.
The present study sought to examine the relationships between systemic inflammatory composite ratios/cumulative scores, magnitude of systemic inflammatory response (SIR) and survival in good performance status patients (ECOG-PS 0/1) with advanced NSCLC receiving palliative radiotherapy.
Systemic inflammatory composite ratios/cumulative scores included the neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), lymphocyte-monocyte ratio (LMR), C-reactive protein, (CRP)-albumin ratio (CAR), neutrophil- lymphocyte score (NLS), platelet-lymphocyte score (PLS), lymphocyte-monocyte score (LMS), neutrophil-platelet score (NPS), modified Glasgow prognostic score (mGPS). The magnitude of SIR was determined by serum CRP concentration, with a median CRP concentration of >10 m mg/L considered to be systemically inflamed. Relationships between systemic inflammatory composite ratios/ cumulative scores and clinicopathological characteristics were examined using chi-square analysis. Relationships between overall survival (OS) and systemic inflammatory composite ratios/ cumulative scores were examined using cox regression analysis.
479 patients were included. 48% (n = 231) of patients were male and 70% (n = 338) were ≥65 years of age. 29% (n = 140) patients were ECOG-PS 0 and 71% (n = 339) were ECOG-PS 1. 98% (n = 469) of patients died during follow-up. The median survival was 5 months (2-11). A similar prevalence of systemic inflammation was noted across the various ratios/scores (NLR >3 68%; LMR <2.4 65%; PLR >150 70%; CAR >0.20 83%; NLS ≥1 66%; LMS ≥1 71%; NPS≥1 50%; PLS≥1 60% and mGPS≥1 75%). Despite not considered to be systemically inflamed, an NLR <3, LMR ≥2.4, PLR ≤150, NLS 0, LMS 0, NPS 0 and PLS 0 all had a median CRP concentration of >10 mg/L. When adjusted for ECOG-PS, CAR>0.40 (p < 0.001) and mGPS 2 (p < 0.05) remained significantly associated with OS.
Liver-based measures of systemic inflammation (CAR and mGPS) appear more reliable for the quantification of the magnitude of SIR and have prognostic value in patients with advanced NSCLC.
本研究旨在探讨全身炎症复合比/累积评分、全身炎症反应程度（SIR）与接受姑息性放疗的体能状态良好（ECOG-PS 0/1）的晚期 NSCLC 患者的生存之间的关系。
全身炎症复合比/累积评分包括中性粒细胞-淋巴细胞比（NLR）、血小板-淋巴细胞比（PLR）、淋巴细胞-单核细胞比（LMR）、C 反应蛋白（CRP）-白蛋白比（CAR）、中性粒细胞-淋巴细胞评分（NLS）、血小板-淋巴细胞评分（PLS）、淋巴细胞-单核细胞评分（LMS）、中性粒细胞-血小板评分（NPS）、改良格拉斯哥预后评分（mGPS）。SIR 的程度通过血清 CRP 浓度确定，以中位数 CRP 浓度>10mg/L 作为全身性炎症。采用卡方检验分析全身炎症复合比/累积评分与临床病理特征的关系。采用 COX 回归分析全身炎症复合比/累积评分与总生存（OS）的关系。
共纳入 479 例患者。48%（n=231）为男性，70%（n=338）年龄≥65 岁。29%（n=140）的患者 ECOG-PS 评分为 0，71%（n=339）的患者 ECOG-PS 评分为 1。98%（n=469）的患者在随访期间死亡。中位生存时间为 5 个月（2-11）。各种比值/评分的全身性炎症发生率相似（NLR>3 为 68%；LMR<2.4 为 65%；PLR>150 为 70%；CAR>0.20 为 83%；NLS≥1 为 66%；LMS≥1 为 71%；NPS≥1 为 50%；PLS≥1 为 60%，mGPS≥1 为 75%）。尽管未被认为是全身性炎症，但 NLR<3、LMR≥2.4、PLR≤150、NLS 0、LMS 0、NPS 0 和 PLS 0 的中位 CRP 浓度均>10mg/L。在校正 ECOG-PS 后，CAR>0.40（p<0.001）和 mGPS 2（p<0.05）仍与 OS 显著相关。
基于肝脏的全身炎症指标（CAR 和 mGPS）似乎更能可靠地量化 SIR 的程度，并对晚期 NSCLC 患者具有预后价值。
