免疫检查点抑制剂联合化疗治疗非小细胞肺癌后免疫相关不良事件的发生状况及影响因素探究

Occurrence and influencing factors of immune-related adverse events in patients with non-small cell lung cancer treated with immune checkpoint inhibitors combined with chemotherapy

目的:探讨非小细胞肺癌(Non-small cell lung cancer,NSCLC)患者经免疫检查点抑制剂(Immune checkpoint inhibitors,ICIs)治疗后免疫相关不良事件(Immune-related adverse events,irAE)发生情况及危险因素分析。方法:回顾性分析2019年1月至2022年1月在本院接受免疫检查点抑制剂治疗的98例NSCLC患者为研究对象。根据治疗后有无发生免疫相关不良反应将NSCLC患者分为irAE组(n=53)和未发生组(n=45)。分析比较两组NSCLC患者的临床资料。采用Logistic回归分析影响NSCLC患者发生免疫相关不良反应的危险因素。结果:irAE组NSCLC患者的绝对淋巴细胞计数(Absolute lymphocyte count,ALC)、绝对嗜酸性粒细胞计数(Absolute eosinophil count,AEC)、血小板淋巴细胞比值(Platelet-to-lymphocyte ratio,PLR)水平均高于未发生组,中性粒细胞与淋巴细胞比值(Neutrophil-to-lymphocyte ratio,NLR)水平低于未发生组,差异有统计学意义(P<0.05),Logistic回归显示,ALC水平偏高(OR=4.477,P=0.001)是影响NSCLC患者发生irAE的独立危险因素。结论:ALC水平偏高是影响NSCLC患者发生irAE的独立危险因素。

Objective:To investigate the incidence and risk factors of immune-related adverse events(irAE)in patients with non-small cell lung cancer(NSCLC)treated with immune checkpoint inhibitors(ICIs).Methods:98 patients with NSCLC treated with immune checkpoint inhibitors in our hospital from January 2019 to January 2022 were retrospectively analyzed.NSCLC patients were divided into irAE group(n=53)and non-NSCLC group(n=45)according to whether immune-related adverse reactions occurred after treatment.The clinical data of NSCLC patients in the two groups were analyzed and compared.Logistic regression was used to analyze the risk factors for immune-related adverse reactions in NSCLC patients.Results:The levels of absolute lymphocyte count(ALC),absolute eosinophil count,(AEC)and platelet-to-lymphocyte ratio(PLR)of NSCLC patients in irAE group were higher than those in non-CLC group,and the levels of neutrophil-to-lymphocyte ratio(NLR)were lower than those in non-CLC group(P<0.05).Logistic regression showed that ALC level was higher(OR=4.477,P=0.001)was an independent risk factor for irAE in NSCLC patients.Conclusion:High ALC level is an independent risk factor for irAE in NSCLC patients.