循环肿瘤细胞、中性粒细胞/淋巴细胞比值对晚期非小细胞肺癌患者疗效及预后预测价值研究

The efficacy and prognostic value of circulating tumor cells and neutrophil/lymphocyte ratio in patients with advanced non-small cell lung cancer

目的 分析循环肿瘤细胞(CTC)、中性粒细胞/淋巴细胞比值(NLR)在晚期非小细胞肺癌(NSCLC)疗效评估、预后预测中的应用。方法 选取2018年2月至2021年2月我院就诊的134例晚期NSCLC患者,对比化疗前后、不同疗效NSCLC患者CTC、NLR水平;收集患者预后1年生存情况,分析NSCLC患者预后的影响因素以及CTC、NLR在晚期NSCLC患者预后中的预测价值。结果 与化疗前比较,化疗后CTC数量减少,NLR水平下降(P<0.05);治疗后有效组CTC数量、NLR水平均低于无效组(P<0.05);预后生存组CTC数量、NLR水平均低于死亡组(P<0.05);临床分期Ⅳ期、吸烟、有远处转移、CTC及NLR升高为晚期NSCLC预后死亡的独立危险因素(P<0.05);CTC、NLR联合检测预测NSCLC患者预后死亡价值更高(P<0.05)。结论 联合检测CTC及NLR更有利于评估NSCLC患者疗效、预后,可更好的指导NSCLC患者的临床治疗及预后评估。

Objective To analyze the application of circulating tumor cells(CTC) and neutrophil/lymphocyte ratio(NLR) in the efficacy evaluation and prognosis prediction of advanced non-small cell lung cancer(NSCLC).Methods One hundred and thirty-four patients with advanced NSCLC who were treated in our hospital from February 2018 to February 2021 were selected. The levels of CTC and NLR in NSCLC patients with different curative effects before and after chemotherapy were compared. The 1-year survival data of patients were collected. The related factors affecting the prognosis of patients with NSCLC, and the predictive value of CTC and NLR in the prognosis of patients with advanced NSCLC were analyzed.Results After chemotherapy, the number of CTC and the level of NLR were reduced when compared with that before chemotherapy(P<0.05). After treatment, the number of CTC and the level of NLR in the effective group were lower than those in the ineffective group(P<0.05). The number of CTCs and the level of NLR in the survival group were lower than those in the death group(P<0.05). Clinical stage IV, smoking, distant metastasis, elevated CTC and NLR were all independent risk factors for the prognosis and death of advanced NSCLC(P<0.05). The combined detection of CTC and NLR was more valuable in predicting the prognosis and mortality of NSCLC patients(P<0.05).Conclusions The combined detection of CTC and NLR is more beneficial to evaluate the efficacy and prognosis of NSCLC patients. It can better guide the clinical treatment and prognosis assessment of the NSCLC patients.