Department of Plastic and Aesthetic Surgery, Affiliated Hospital of Shaanxi University of Chinese Medicine, Shaanxi, China.
Department of Burns and Plastic Surgery, 969th Hospital of PLA Joint Logistic Support Force, Inner Mongolia, China.
Front Immunol. 2024 Oct 18;15:1482746. doi: 10.3389/fimmu.2024.1482746. eCollection 2024.
Immune checkpoint inhibitors (ICIs) are an emerging tumor treatment pathway after traditional surgery, chemoradiotherapy, and targeted therapy. They have proven to be effective in a variety of cancers, but may not respond to non-target populations. Inflammatory markers such as neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), lymphocyte to monocyte ratio (LMR), derived neutrophil lymphocyte ratio (dNLR), and neutrophil count (ANC) have been shown to be strongly associated with tumor prognosis, but their prognostic significance remains controversial. We therefore performed a meta-analysis to explore the association between NLR, PLR, LMR, dNLR, ANC and prognostic and clinicopathological factors in melanoma patients treated with ICIs.
A comprehensive search was conducted in Pubmed, Embase, Web Of Science and Cochrane databases, and the last search time was July 2024. To estimate the prognostic value of NLR, PLR, LMR, dNLR, ANC for PFS and OS, hazard ratio (HR) and corresponding 95% confidence interval (CI) estimates were used.
This meta-analysis ultimately included 22 cohort studies involving 3235 melanoma patients. Meta-analysis results showed that high levels of NLR in melanoma patients receiving ICIs were associated with poorer OS and PFS, Merging the HR respectively OS [HR = 2.21, 95% CI (1.62, 3.02), P < 0.001], PFS [HR = 1.80, 95% CI (1.40, 2.30), P < 0.001]; High levels of PLR were associated with poor OS and PFS, and the combined HR was OS[HR=2.15,95%CI(1.66,2.80),P < 0.001] and PFS[HR=1.67,95%CI(1.31,2.12),P < 0.001]. High levels of dNLR were associated with poor OS and PFS, with combined HR being OS[HR=2.34,95%CI(1.96,2.79),P < 0.001] and PFS[HR=2.05,95%CI(1.73,2.42),P < 0.001], respectively. High ANC was associated with poor OS and PFS, and combined HR was OS[HR=1.95,95%CI(1.16,3.27),P < 0.001] and PFS[HR=1.63,95%CI(1.04,2.54),P=0.032], respectively. Increased LMR was associated with prolonged OS and PFS, with combined HR being OS[HR=0.36, 95%CI(0.19,0.70),P < 0.001] and PFS[HR=0.56,95%CI(0.40,0.79),P=0.034], respectively.
In melanoma patients treated with ICIs, elevated levels of NLR, PLR, dNLR, and ANC were associated with poorer overall survival OS and PFS. Conversely, a high LMR correlated with improved OS and PFS. Subgroup analyses indicated that dNLR may be linked to a worse prognosis in melanoma patients. In summary, inflammatory markers such as NLR, PLR, LMR, dNLR, and ANC serve as effective biomarkers for the prognostic assessment of melanoma patients following ICI treatment. These markers provide valuable insights for treatment decision-making in the realm of melanoma immunotherapy, and we anticipate further high-quality prospective studies to validate our findings in the future.
https://www.crd.york.ac.uk/PROSPERO/#recordDetails, identifier CRD42024573406.
免疫检查点抑制剂（ICIs）是继传统手术、放化疗和靶向治疗之后新兴的肿瘤治疗途径。它们已被证明在多种癌症中有效，但可能对非目标人群没有反应。中性粒细胞与淋巴细胞比值（NLR）、血小板与淋巴细胞比值（PLR）、淋巴细胞与单核细胞比值（LMR）、衍生中性粒细胞淋巴细胞比值（dNLR）和中性粒细胞计数（ANC）等炎症标志物已被证明与肿瘤预后密切相关，但它们的预后意义仍存在争议。因此，我们进行了一项荟萃分析，以探讨在接受 ICI 治疗的黑色素瘤患者中，NLR、PLR、LMR、dNLR 和 ANC 与预后和临床病理因素之间的关系。
在 Pubmed、Embase、Web Of Science 和 Cochrane 数据库中进行了全面搜索，最后一次搜索时间为 2024 年 7 月。为了估计 NLR、PLR、LMR、dNLR 和 ANC 对 PFS 和 OS 的预后价值，使用了风险比（HR）和相应的 95%置信区间（CI）估计值。
这项荟萃分析最终纳入了 22 项队列研究，涉及 3235 名黑色素瘤患者。荟萃分析结果表明，黑色素瘤患者接受 ICI 治疗时 NLR 水平较高与 OS 和 PFS 较差相关，合并的 HR 分别为 OS [HR=2.21，95%CI（1.62，3.02），P<0.001]，PFS [HR=1.80，95%CI（1.40，2.30），P<0.001]；PLR 水平较高与 OS 和 PFS 较差相关，合并的 HR 为 OS [HR=2.15，95%CI（1.66，2.80），P<0.001]和 PFS [HR=1.67，95%CI（1.31，2.12），P<0.001]；dNLR 水平较高与 OS 和 PFS 较差相关，合并的 HR 分别为 OS [HR=2.34，95%CI（1.96，2.79），P<0.001]和 PFS [HR=2.05，95%CI（1.73，2.42），P<0.001]；ANC 水平较高与 OS 和 PFS 较差相关，合并的 HR 分别为 OS [HR=1.95，95%CI（1.16，3.27），P<0.001]和 PFS [HR=1.63，95%CI（1.04，2.54），P=0.032]；LMR 水平较高与 OS 和 PFS 延长相关，合并的 HR 分别为 OS [HR=0.36，95%CI（0.19，0.70），P<0.001]和 PFS [HR=0.56，95%CI（0.40，0.79），P=0.034]。
在接受 ICI 治疗的黑色素瘤患者中，NLR、PLR、dNLR 和 ANC 水平升高与总生存期（OS）和无进展生存期（PFS）较差相关。相反，较高的 LMR 与 OS 和 PFS 改善相关。亚组分析表明，dNLR 可能与黑色素瘤患者的预后不良相关。总之，NLR、PLR、LMR、dNLR 和 ANC 等炎症标志物可作为评估黑色素瘤患者接受 ICI 治疗后预后的有效生物标志物。这些标志物为黑色素瘤免疫治疗的治疗决策提供了有价值的见解，我们预计未来会有更多高质量的前瞻性研究来验证我们的发现。
https://www.crd.york.ac.uk/PROSPERO/#recordDetails，标识符 CRD42024573406。
