动态监测NLR、PLR变化与晚期肺腺癌一线化疗疗效及预后关系

Relationship between dynamic monitoring NLR and PLR,and efficacy of first-line chemotherapy and prognosis of advanced lung adenocarcinoma

目的:探讨中性粒细胞淋巴细胞比率(NLR)及血小板淋巴细胞比率(PLR)的动态变化对晚期肺腺癌病人化疗疗效及生存期的预测价值。方法:回顾性分析193例经一线化疗的晚期肺腺癌病人病历资料,收集其化疗前、化疗2周期后及化疗4周期后的相关资料进行疗效评定,并分别计算NLR、PLR;分析NLR、PLR的动态变化与各种临床特征、一线化疗疗效及总生存期(OS)之间的关系。结果:NLR、PLR水平在化疗前及化疗后疾病进展组均高于完全缓解+部分缓解+疾病稳定组(P<0.01);在化疗疗效方面,除NLR4(P>0.05)外,NLR0、NLR2、PLR0、PLR2、PLR4与2周期化疗疗效呈负相关关系(P<0.05~P<0.01);而NLR0、NLR2、NLR4、PLR0、PLR2、PLR4与4周期化疗疗效均呈负相关关系(P<0.01);Kaplan-Meier生存分析表明,OS在不同NLR0、NLR4、PLR0、PLR2、PLR4、2周期化疗疗效及4周期化疗疗效中差异均有统计学意义(P<0.01),且多因素分析表明,NLR0与PLR4是生存期的独立危险因素(P<0.05和P<0.01)。结论:NLR、PLR与一线化疗晚期肺腺癌疗效及生存密切相关,治疗前NLR与化疗4周后PLR是一线化疗晚期肺腺癌病人的独立预后因素。

Objective:To investigate the predictive value of dynamic monitoring the neutrophil-to-lymphocyte ratio(NLR)and platelet-to-lymphocyte ratio(PLR)in the chemotherapeutic effects and lifetime of lung adenocarcinoma patients.Methods:The clinical data of 193 advanced lung adenocarcinoma patients treated with first-line chemotherapy were retrospectively analyzed.The relevant data of patients before chemotherapy,after 2 and 4 cycles of chemotherapy were collected.The curative effects of patients were evaluated,and the NLR and PLR were calculated.The relationship between the dynamic changes of NLR and PLR,and various clinical features,first-line chemotherapy efficacy and overall survival(OS)were analyzed.Results:The levels of NLR and PLR in PD group before and after chemotherapy were higher than those in CR group,PR group and SD group(P<0.01).In terms of the efficacy of chemotherapy,except for NLR4(P>0.05),the NLR0,NLR0,PLR0,PLR2 and PLR4 were negatively correlated with the efficacy of 2-cycle chemotherapy(P<0.05 to P<0.01).The NLR0,NLR2,NLR4,PLR0,PLR2 and PLR4 were negatively correlated with the efficacy of 4-cycle chemotherapy(P<0.01).The results of Kaplan-Meier survival analysis showed that the OS was significantly correlated with the NLR0,NLR4,PLR0,PLR2,PLR4,efficacy of 2-cycle chemotherapy and efficacy of 4-cycle chemotherapy(P<0.01).The results of multivariate analysis showed that the NLR0 and PLR4 were the independent risk factors of survival(P<0.05 and P<0.01).Conclusions:The NLR and PLR are closely related to the efficacy and survival of first-line chemotherapy for advanced lung adenocarcinoma.The NLR before treatment and PLR after 4 cycle chemotherapy are the independent prognostic factors of advanced lung adenocarcinoma patients treated with first-line chemotherapy.