Department of Oncology, The Fifth Hospital of WuHan, WuHan, 430000, Hubei, China.
Department of Nursing, The Fifth Hospital of WuHan, WuHan, 430000, Hubei, China.
Sci Rep. 2024 Oct 30;14(1):26102. doi: 10.1038/s41598-024-76052-2.
This study aimed to explore the association between inflammation-based prognostic markers and outcomes in non-small cell lung cancer (NSCLC) patients undergoing therapy with immune checkpoint inhibitors (ICIs). We conducted a comprehensive search of the Embase, PubMed, and Cochrane databases for studies that reported on the impact of inflammation-based prognostic factors, such as C-reactive protein (CRP), on the prognosis of NSCLC patients treated with ICIs. The primary outcomes of interest were overall survival (OS) and progression-free survival (PFS). Statistical analyses were performed using Stata 14 software, with assessments of publication bias and heterogeneity conducted as necessary. Our meta-analysis included 27 studies encompassing 5,174 patients, evaluating factors such as CRP, the modified Glasgow Prognostic Score (mGPS), and the CRP-albumin ratio (CAR). The analysis revealed that elevated levels of CRP were significantly correlated with both reduced PFS (I = 0%, P = 0.72; HR = 1.50, 95%CI: 1.33-1.67, P < 0.01) and shorter OS (I = 0%, P = 0.55; HR = 1.90, 95%CI: 1.50-2.30, P < 0.01). Similarly, elevated levels of mGPS values were associated with worse PFS (I = 0%, P = 0.75; HR = 1.28, 95%CI: 1.10-1.46, P < 0.05) and OS (I = 0%, P = 0.94; HR = 1.56, 95%CI: 1.31-1.81, P < 0.05). However, the relationship between elevated levels of CAR and worse outcomes for PFS (I = 59.6%, P = 0.94; HR = 1.42, 95%CI: 0.74-2.11, P > 0.05) and OS (I = 45.3%, P = 0.16; HR = 1.41, 95%CI: 0.70-2.13, P > 0.05) was not statistically significant. Our findings suggest that CRP and mGPS may serve as potential prognostic markers in NSCLC patients receiving immunotherapy. Nonetheless, further research with more homogeneous study populations is necessary to valid these observations.
这项研究旨在探讨炎症标志物与接受免疫检查点抑制剂 (ICI) 治疗的非小细胞肺癌 (NSCLC) 患者结局之间的关联。我们对 Embase、PubMed 和 Cochrane 数据库进行了全面检索，以寻找报告 C 反应蛋白 (CRP) 等炎症标志物对接受 ICI 治疗的 NSCLC 患者预后影响的研究。主要结局指标为总生存期 (OS) 和无进展生存期 (PFS)。使用 Stata 14 软件进行统计分析，并根据需要评估发表偏倚和异质性。我们的荟萃分析纳入了 27 项研究，共纳入 5174 例患者，评估了 CRP、改良格拉斯哥预后评分 (mGPS) 和 CRP-白蛋白比值 (CAR) 等因素。分析结果显示，CRP 水平升高与 PFS 缩短 (I ² = 0%，P = 0.72；HR = 1.50，95%CI：1.33-1.67，P < 0.01) 和 OS 缩短 (I ² = 0%，P = 0.55；HR = 1.90，95%CI：1.50-2.30，P < 0.01) 显著相关。同样，mGPS 值升高与 PFS 缩短 (I ² = 0%，P = 0.75；HR = 1.28，95%CI：1.10-1.46，P < 0.05) 和 OS 缩短 (I ² = 0%，P = 0.94；HR = 1.56，95%CI：1.31-1.81，P < 0.05) 相关。然而，CAR 水平升高与 PFS 结局较差之间的关系 (I ² = 59.6%，P = 0.94；HR = 1.42，95%CI：0.74-2.11，P > 0.05) 和 OS 结局较差 (I ² = 45.3%，P = 0.16；HR = 1.41，95%CI：0.70-2.13，P > 0.05) 不具有统计学意义。我们的研究结果表明，CRP 和 mGPS 可能是接受免疫治疗的 NSCLC 患者潜在的预后标志物。然而，需要更多同质研究人群的进一步研究来验证这些观察结果。
