接受免疫检查点抑制剂治疗晚期肾癌患者血小板-淋巴细胞比和全身免疫炎症指数与预后关系

Relationship between platelet-to-lymphocyte ratio and systemic immune-inflammation index and prognostic outcomes in patients with advanced renal cell carcinoma treated with immune checkpoint inhibitors

目的探究血小板-淋巴细胞比(PLR)和全身免疫炎症指数(SII)对接受免疫检查点抑制剂治疗的晚期肾癌患者预后价值。方法回顾性分析2018-06-01-2020-06-30山东省肿瘤医院收治的52例晚期肾癌患者临床资料,纳入患者均接受免疫检查点抑制剂治疗,收集每次免疫治疗前的PLR和SII。多因素Logistic回归分析PLR和SII与疾病控制率(DCR)的关系,生存时间曲线用Kaplan-Meier法计算,采用多因素Cox回归评估PLR和SII与无进展生存期(PFS)和总生存期(OS)等预后指标的关系。结果受试者工作特征(ROC)曲线分析确定PLR和SII的最佳临界值分别为317.83和1388.73。低PLR组(PLR≤317.83)和低SII组(SII≤1388.73)与更好的DCR(OR=11.20,95%CI:2.48~50.64,P=0.002;OR=5.36,95%CI:1.09~26.29,P=0.039)有关联。多因素Cox显示,PLR>317.83和SII>1388.73是PFS(HR=7.02,95%CI:1.56~31.61,P=0.011;HR=15.84,95%CI:3.04~82.59,P=0.001)和OS(HR=6.56,95%CI:1.26~34.08,P=0.025;HR=18.14,95%CI:3.08~106.89,P=0.001)的独立危险因素;PLR>317.83和SII>1388.73与较差的PFS(P=0.002;P<0.001)和OS(P=0.019;P<0.001)相关。结论PLR和SII是预测接受免疫检查点抑制剂治疗晚期肾癌患者预后的有效临床指标,且高PLR和高SII与不良预后有关。

Objective To investigate the prognostic value of platelet-to-lymphocyte ratio(PLR)and systemic immune-inflammation index(SII)in advanced renal cell carcinoma(aRCC)patients treated with immune checkpoint inhibitors.Methods The clinical data of fifty-two patients with advanced renal cell carcinoma admitted to Shandong Cancer Hospital from June 1,2018 to June 30,2020 were retrospectively analyzed.All patients were treated with immune checkpoint inhibitors,and PLR and SII before each immunotherapy were collected.The relationship between PLR,SII and disease control rate(DCR)was analyzed by multivariate Logistic regression.The survival time curve was calculated by Kaplan-Meier method.Multivariate Cox regression was used to evaluate the relationship between PLR,SII and prognostic indicators such as progression-free survival(PFS)and overall survival(OS).Results Receiver operating characteristic(ROC)curve analysis determined that the optimal cut-off values of PLR and SII were 317.83 and 1388.73,respectively.The low PLR group(PLR≤317.83)and low SII group(SII≤1388.73)were correlated with better DCR(OR=11.20,95%CI:2.48-50.64,P=0.002;OR=5.36,95%CI:1.09-26.29,P=0.039).Multivariate Cox showed that PLR>317.83and SII>1388.73were independent risk factors for PFS(HR=7.02,95%CI:1.56-31.61,P=0.011;HR=15.84,95%CI:3.04-82.59,P=0.001)and OS(HR=6.56,95%CI:1.26-34.08,P=0.025;HR=18.14,95%CI:3.08-106.89,P=0.001),and PLR>317.83and SII>1388.73were associated with poor PFS(P=0.002;P<0.001)and OS(P=0.019;P<0.001).Conclusions PLR and SII are effective clinical indicators of prognosis in patients with advanced renal cell carcinoma treated with immune checkpoint inhibitors,and high PLR and SII are associated with poor prognosis.