接受免疫治疗的非小细胞肺癌患者系统性炎症反应的预后/预测价值：一项系统评价和荟萃分析
The prognostic/ predictive value of the systematic inflammatory response in patients receiving immunotherapy for non-small cell lung cancer: a systematic review and meta-analysis.
作者信息
Saeed Randa, McSorley Stephen, Cascales Almudena, McMillan Donald C
机构信息
Academic Unit of Surgery, School of Medicine, University of Glasgow, Glasgow Royal Infirmary, Glasgow, New Lister Building, G31 2ERLevel2, UK.
Consultant Clinical Oncologist, Edinburgh Cancer Centre, Western General Hospital, Edinburgh, Scotland, UK.
出版信息
BMC Cancer. 2025 Jun 4;25(1):994. doi: 10.1186/s12885-025-13822-9.
BACKGROUND
The second most common malignancy after breast cancer is lung cancer (LC). Small cell lung cancer accounts for 15%, while non-small lung cancer (NSCLC) accounts for 85% of cases. Immunotherapy has improved treatment outcomes in NSCLC. However, the role of systemic inflammation-based prognostic scores in predicting response to treatment is not clear. The meta-analyses aims to evaluate the prognostic/ predictive value of inflammatory biomarkers, including NLR, ALI, PLR, CRP, and mGPS, and their potential associated with overall survival in NSCLC patients receiving immunotherapy as first-line or second-line treatment.
METHODS
A systematic review and meta-analysis was conducted following the Cochrane Handbook and PRISMA guidelines. Searches were performed in PubMed, Cochrane Library, and Web of Science for studies published until January 1, 2022, using specific keywords related to NSCLC, immunotherapy, inflammatory biomarkers and survival. Meta-analysis was performed using RevMan software, analyzing the hazard ratio (HRs) with a 95% confidence interval (CIs) primarily in relation to overall survival.
RESULTS
Six thirty three records were identified, and 17 articles were included in the meta-analysis. The pooled analysis of NLR, ALI, PLR, CRP, and mGPS was significantly associated with OS without significant heterogeneity (NLR: HR = 2.15; 95% CI 1.60 - 2.87; P-Value < 0.00001); (ALI: HR = 2.03; 95% CI 1.43 - 2.88; P-Value < 0.0001); (PLR: HR = 4.06; 95% CI 2.14 - 7.67; P-Value < 0.0001); (CRP: HR = 5.37; 95% CI 3.90 - 7.39; P-Value < 0.00001); and (mGPS: HR = 3.27; 95% CI 1.26 - 8.28; P-Value = 0.01), respectively.
CONCLUSIONS
Systemic inflammatory biomarkers demonstrate independent prognostic/ predictive value in patients with advanced non-small cell lung cancer who receive immunotherapy as either the first-line or second-line therapy.
背景
肺癌（LC）是仅次于乳腺癌的第二大常见恶性肿瘤。小细胞肺癌占15%，而非小细胞肺癌（NSCLC）占病例的85%。免疫疗法改善了NSCLC的治疗结果。然而，基于全身炎症的预后评分在预测治疗反应中的作用尚不清楚。本荟萃分析旨在评估炎症生物标志物（包括中性粒细胞与淋巴细胞比值（NLR）、白蛋白与球蛋白比值（ALI）、血小板与淋巴细胞比值（PLR）、C反应蛋白（CRP）和改良格拉斯哥预后评分（mGPS））的预后/预测价值，以及它们与接受一线或二线免疫治疗的NSCLC患者总生存的潜在关联。
方法
按照Cochrane手册和PRISMA指南进行系统评价和荟萃分析。在PubMed、Cochrane图书馆和科学网中进行检索，以查找截至2022年1月1日发表的研究，使用与NSCLC、免疫疗法、炎症生物标志物和生存相关的特定关键词。使用RevMan软件进行荟萃分析，主要分析与总生存相关的风险比（HR）及95%置信区间（CI）。
结果
共识别出633条记录，17篇文章纳入荟萃分析。NLR、ALI、PLR、CRP和mGPS的汇总分析与总生存显著相关，且无显著异质性（NLR：HR = 2.15；95% CI 1.60 - 2.87；P值<0.00001）；（ALI：HR = 2.03；95% CI 1.43 - 2.88；P值<0.0001）；（PLR：HR = 4.06；95% CI 2.14 - 7.67；P值<0.0001）；（CRP：HR = 5.37；95% CI 3.90 - 7.39；P值<0.00001）；以及（mGPS：HR = 3.27；95% CI 1.26 - 8.28；P值 = 0.01）。
结论
全身炎症生物标志物在接受一线或二线免疫治疗的晚期非小细胞肺癌患者中显示出独立的预后/预测价值。
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