血清炎症标志物对肺癌患者远处转移的预测价值

Predictive value of serum inflammatory markers as predictors for distant metastasis in patients with lung cancer

目的探讨肺癌患者首诊治疗前血清炎症标志物对远处转移的预测价值。方法回顾性分析2023年6月至2024年6月首次确诊原发性肺癌的患者接受治疗前的临床资料。根据是否存在远处转移将患者分为两组,比较两组资料的差异性。将单因素分析P<0.2的指标进行多因素分析,采用ROC曲线评价各指标对肺癌发生远处转移的预测价值。结果共入组244例患者,其中大部分为男性(61.9%),平均年龄(62.7±12.6)岁。两组患者在年龄、性别、嗜酸性粒细胞、嗜碱性粒细胞方面的差异均无统计学意义。在单变量分析中,两组患者的肿瘤大小、白细胞计数、中性粒细胞数、淋巴细胞数、单核细胞数、NLR、LMR、PLR、SII均存在显著差异(P<0.001)。在多因素分析中,肿瘤大小(OR=39.769,95%CI:16.140~97.992,P<0.001)及PLR(OR=3.291,95%CI:1.045~10.360,P=0.042)与远处转移有关。根据ROC曲线,PLR的AUC为0.745(95%CI:0.683~0.806),临界值为140.655,敏感度为65.6%,特异度为73.8%(P<0.001)。结论高水平的PLR提示肺癌发生远处转移的风险较高,这表明PLR可能是早期识别肺癌转移的重要临床特征。

Objective To investigate the predictive value of serum systemic inflammatory markers for distant metastasis in patients with lung cancer before initial treatment.Methods A retrospective analysis was conducted on patients who were first diagnosed with primary lung cancer from June 2023 to June 2024.The patients were divided into two groups based on the existence of distant metastasis,and a comparative analysis was conducted to assess the differences in data between the two groups.Subsequently,multivariate analysis was performed for variables with P<0.2,while the predictive value of each variable for distant metastasis of lung cancer was evaluated by ROC curve analysis.Results A total of 244 patients were enrolled,most of whom were male(61.9%),with an average age of(62.7±12.6)years old.The two groups showed no significant difference in age,gender,eosinophils and basophils.In univariate analysis,there were significant differences in tumor size,white blood cell count,neutrophils,lymphocytes,monocytes,NLR,LMR,PLR,and SII between the two groups(P<0.001).In multivariate analysis,tumor size(OR=39.769,95%CI:16.140~97.992,P<0.001)and PLR(OR=3.291,95%CI:1.045~10.360,P=0.042)were associated with distant metastasis.According to the ROC curve,the PLR had an AUC of 0.745(95%CI:0.683~0.806)with a cut-off value of 140.655,demonstrating a sensitivity of 65.6%and specificity of 73.8%(P<0.001).Conclusion A high level of PLR indicates an elevated risk of distant metastasis in patients with lung cancer,suggesting that PLR may serve as an important clinical marker for early identification of lung cancer metastasis.