晚期NSCLC患者外周血炎性标记物与EGFR-TKIs靶向治疗相关预后的关联及研究进展

Advances in Correlation between Peripheral Blood Inflammatory Markers and Prognosis of Advanced Stage Non-Small Cell Lung Cancer Patients by EGFR-TKIs Targeted Therapy

肺癌是全球范围内死亡率最高的恶性肿瘤,严重威胁着人类健康。针对携带表皮生长因子受体(epidermal growth factor receptor, EGFR)敏感突变的晚期非小细胞肺癌(non-small cell lung cancer, NSCLC)患者的靶向治疗展现了显著的疗效和良好的耐受性,成为指南推荐的标准一线治疗,但仍面临耐药的问题,并且目前尚缺乏有效的预测预后指标。持续的慢性炎症反应与肿瘤的发生、发展、转移等过程密切相关。外周血检测具有价格低、容易获取、创伤性小、可重复性好等特点,目前在临床广泛应用,其中炎症相关的指标,如中性粒细胞与淋巴细胞计数比值、血小板与淋巴细胞计数比值、淋巴细胞与单核细胞计数比值和系统免疫炎症指数等,在预测肺癌化疗、放疗、免疫治疗的预后方面均已有报道。本文拟归纳及分析外周血炎症相关指标与晚期EGFR突变NSCLC患者靶向治疗的预后的相关性作一综述,为改善NSCLC患者的预后和及时调整治疗方案等提供临床依据。

Lung cancer is the most lethal malignant tumor in the world, which seriously threatens people’s health. Targeted therapies for advanced non-small cell lung cancer(NSCLC) with epidermal growth factor receptor(EGFR) sensitive mutations has demonstrated significant efficacy and good tolerability, which has become the standard first-line treatment recommended by guidelines. However, drug resistance is still a problem, and there is still a lack of effective prognostic indicators. Continuous chronic inflammatory response is closely related to the occurrence, development and metastasis of tumors. Peripheral blood detection is characterized by low cost, easy access, less trauma and good reproducibility, and is widely used in clinical practice. Among them, inflammation-related indicators, such as neutrophil-to-lymphocyte ratio, plateletto-lymphocyte ratio, lymphocyte-to-monocyte ratio and systemic immune-inflammation index have been reported to predict the prognosis of lung cancer after chemotherapy, radiotherapy and immunotherapy. This article aims to summarize and analyze the correlation between peripheral blood inflammation-related indicators and the prognosis of advanced EGFR-mutant NSCLC patients treated with TKIs, providing a clinical basis for improving the prognosis of NSCLC patients and timely adjusting the treatment plans.