在接受姑息性放疗的身体状况良好的晚期、不可手术的非小细胞肺癌患者中，全身炎症的流行率和预后价值：复合比和累积评分的比较。

The prevalence and prognostic value of systemic inflammation in good performance status patients with advanced, inoperable non-small cell lung cancer receiving palliative radiotherapy: Comparison of composite ratios and cumulative scores.

机构信息

Academic Unit of Surgery, University of Glasgow, Glasgow, UK.

Department of Oncology, Beatson West of Scotland Cancer Centre, Glasgow, UK.

出版信息

Cancer Med. 2024 Aug;13(16):e70139. doi: 10.1002/cam4.70139.

DOI:10.1002/cam4.70139

PMID:39164973

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11335809/

Abstract

INTRODUCTION

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.

METHODS

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.

RESULTS

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.

CONCLUSION

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.

摘要

简介

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。

方法

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。

结果

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。