NLR和SII对PD1/PDL1抑制剂治疗晚期子宫内膜癌患者预后的预测价值

Prognostic Value of NLR and SII in Patients with Advanced EC Treated with PD1/PDL1 Inhibitor

目的 研究中性粒细胞-淋巴细胞比率(NLR)和系统免疫炎症指数(SII)对PD1/PDL1抑制剂治疗晚期子宫内膜癌(EC)患者预后的预测价值。方法 选取2019年11月—2021年11月就诊的146例晚期EC,收集其临床病理资料;以无进展生存期为标准,绘制受试者工作特征(ROC)曲线,计算NLR和SII的最佳截断值,根据最佳截断值分为H/L-NLR组、H/L-SII组,计算各组治疗客观缓解率和疾病控制率,绘制生存曲线评价NLR、SII对PD1/PDL1抑制剂治疗晚期EC患者生存的影响。结果 ROC曲线分析结果显示,当NLR最佳截断值为5.71时,诊断敏感度为52.1%,特异度为79.1%;当SII最佳截断值为803.23时,诊断敏感度为85.1%,特异度为59.9%。L-NLR组和L-SII组疾病控制率分别高于H-NLR组和H-SII组(P<0.01)。L-NLR组和L-SII组中位生存期显著长于H-NLR组和H-SII组。结论 NLR和SII预测PD1/PDL1抑制剂治疗晚期EC患者的价值较高,低于最佳截断值的NLR和SII患者预后较好。

Objective To investigate the prognostic value of neutrophil-lymphocyte ratio(NLR)and systemic immunoinflammatory index(SII)in patients with advanced endometrial cancer(EC)treated with PD1/PDL1 inhibitors.Methods A total of 146 patients with advanced EC admitted from November 2019 to November 2021 were enrolled and their clinicopathological data were collected.The receiver operating characteristic(ROC)curve was drawn based on progression-free survival(PFS),and the optimal cut-off values of NLR and SII were calculated.According to the optimal cut-off values,they were divided into high/low NLR groups(H/L-NLR group),and high/low SII groups(H/L-SII groups)and the objective response rate and disease control rate(DCR)of each group were calculated.Survival curves were drawn to evaluate the effects of NLR and SII on survival of patients with advanced EC treated with PD1/PDL1 inhibitors.Results ROC curve analysis showed that when the optimal cutoff value of NLR was 5.71,the diagnostic sensitivity was 52.1%and the specificity was 79.1%.When the optimal cut-off value of SII was 803.23,the diagnostic sensitivity was 85.1%and the specificity was 59.9%.DCR rates in LNLR and L-SII groups were higher than those in H-NLR and H-SII groups(P<0.01).The median survival of LNLR and L-SII groups was significantly longer than that of H-NLR and H-SII groups.Conclusion NLR and SII can predict the value of PD1/PDL1 inhibitors in the treatment of advanced EC patients,and patients with NLR and SII below the optimal cut-off value have a better prognosis.