摘要
目的:探讨治疗前血清中性粒细胞与淋巴细胞比值(neutrophil to lymphocyte ratio,NLR)和淋巴细胞与单核细胞比值(lympho cyte to monocyte ratio,LMR)对表皮生长因子受体-酪氨酸激酶抑制剂(epidermal growth factor receptor-tyrosine kinase inhibitors,EGFR-TKIs)治疗EGFR突变阳性非小细胞肺癌(non-small cell lung cancer,NSCLC)患者预后的预测价值。方法:回顾性分析112例EGFR突变阳性并接受了EGFR-TKIs治疗的Ⅳ期NSCLC患者的临床资料,根据接受者操作特征曲线(ROC)分析确定的NLR和LMR的最佳分界值,将患者分为高、低水平两组,比较不同分组之间的无进展生存时间(progression free survival,PFS)和总生存时间(overall survival,OS),通过Cox比例风险模型分析影响PFS和OS的独立预后因素。结果:根据ROC曲线,NLR=2.92,LMR=3.81作为评价的分界值。低NLR组和高NLR组的PFS分别为15.6个月和10.5个月(P<0.001),OS分别为26.9个月和19.3个月(P=0.003);高LMR组和低LMR组的PFS分别为13.4个月和11.5个月(P=0.024),OS分别为26.2个月和21.8个月(P=0.020)。通过多因素分析发现,ECOG评分和NLR是影响患者PFS和OS的独立预后因素。结论:治疗前血清NLR水平可作为预测EGFR-TKIs治疗EGFR突变阳性Ⅳ期NSCLC患者的预后因子。
Objective:To investigate the predictive value of pretreatment serum neutrophil-to-lymphocyte ratio(NLR)and lymphocyte-to-monocyte ratio(LMR)for the prognosis of non-small cell lung cancer(NSCLC)harboring EGFR mutations treated with epidermal growth factor receptor-tyrosine kinase inhibitors(EGFR-TKIs).Methods:We retrospectively analyzed 112 cases of stageⅣNSCLC patients harboring EGFR mutations who received EGFR-TKIs.The patients were divided into two groups(high group and low group)with appropriate cutoff point using the receiver operating characteristic(ROC)curve method.The progression free survival(PFS)and overall survival(OS)between different groups were compared.Multivariate analysis was used to identify independent prognostic factor for PFS and OS.Results:According to the ROC curve,the appropriate cutoff point of NLR and LMR were 2.92 and 3.81 respectively.PFS in the low NLR group was significantly longer than PFS in the high NLR group(15.6 vs 10.5 months,P<0.001),OS in the low NLR group was significantly longer than in the high NLR group(26.9 vs 19.3 months,P=0.003).PFS in the high LMR group was longer than PFS in the low LMR group(13.4 vs 11.5 months,P=0.024),OS in the high LMR group was longer than in the low LMR group(26.2 vs 21.8 months,P=0.020).Multivariate analysis found that ECOG scores and pretreatment NLR were independent prognostic factor of PFS and OS.Conclusion:Pretreatment serum NLR level can be used as a predictor of prognosis in stageⅣNSCLC patients harboring EGFR mutations who received EGFR-TKIs.
作者
侯鑫
姚元虎
王建设
王勃
章龙珍
HOU Xin;YAO Yuanhu;WANG Jianshe;WANG Bo;ZHANG Longzhen(Department of Radiotherapy,the Affiliated Hospital of Xuzhou Medical University,Jiangsu Xuzhou 221000,China)
出处
《现代肿瘤医学》
CAS
北大核心
2021年第7期1148-1152,共5页
Journal of Modern Oncology
基金
江苏省卫生健康委科研项目(编号:H2018116)。