| NLR、PLR和SII动态变化与晚期非小细胞肺癌短期疗效和远期预后的关系 |
| 投稿时间：2025-05-07 修订日期：2025-05-25 点此下载全文 |
| 引用本文：朱皖玲,麻利杰,陈昊,嵇桂娟,赵力.NLR、PLR和SII动态变化与晚期非小细胞肺癌短期疗效和远期预后的关系[J].医学研究杂志,2025,54(10):99-104 |
| DOI：
10.11969/j.issn.1673-548X.2025.10.018 |
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| 基金项目:江苏省徐州市科技计划项目(KC20063) |
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| 中文摘要:目的 分析中性粒细胞淋巴细胞比值(neutrophil-to-lymphocyte ratio,NLR)、血小板淋巴细胞比值(platelet-to-lymphocyte ratio,PLR)和全身免疫炎症指数(systemic immune-inflammatory index,SII)与晚期非小细胞肺癌(non-small cell lung cancer,NSCLC)患者短期疗效及远期预后的相关性。方法 采用回顾性研究方法,选取2021年1月～2023年1月在徐州医科大学附属医院呼吸与危重症医学科接受完整4周期化疗联合免疫治疗或者单纯化疗的215例NSCLC患者为研究对象。依据疗效将患者分为缓解组(n=97)和非缓解组(n=118),比较两组患者的NLR、PLR、SII和各指标下降率。通过最佳截断值或者中位数对治疗前后NLR、PLR、SII和下降率进行分组,分析各指标分组无进展生存期和总生存期的差异。结果 缓解组患者每周期治疗前的NLR、PLR均明显低于非缓解组,缓解组第2、3、4周期治疗前SII显著低于非缓解组(P<0.05)；初始治疗至第4周期治疗前,缓解组患者NLR、SII下降率明显高于非缓解组(P<0.05)；肿瘤分期、第4周期治疗前的NLR是晚期NSCLC患者短期疗效的独立影响因素(P<0.05)；第4周期治疗前低NLR、PLR、SII及NLR、SII下降率较高的患者无进展生存期和总生存期更长(P<0.05)。结论 肿瘤分期、第4周期治疗前的NLR与晚期NSCLC患者的短期疗效显著相关,治疗后高NLR往往提示着患者治疗反应较差。治疗后具有较高NLR下降率、较高SII下降率的晚期NSCLC患者预后更佳。 |
| 中文关键词:非小细胞肺癌 短期疗效 NLR PLR SII |
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| Relationship between Dynamic Changes of NLR, PLR, and SII and Short-term Efficacy and Long-term Prognosis of Patients with Advanced Non-small Cell Lung Cancer. |
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| Abstract:Objective To analyze the correlation of neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and systemic immune-inflammatory index (SII) with short-term outcome and long-term prognosis in patients with advanced non-small cell lung cancer (NSCLC). Methods A retrospective study was conducted. A total of 215NSCLC patients who received a complete 4-cycle chemotherapy combined with immunotherapy or chemotherapy alone in the Department of Respiratory and Critical Care Medicine, Affiliated Hospital of Xuzhou Medical University from January 2021 to January 2023 were selected as the research subjects. The patients were divided into remission group (n=97) and non-remission group (n=118) based on the efficacy of the treatments, and the differences in NLR, PLR, SII, and decline rate of each index were compared between the two groups. NLR, PLR, SII and decline rate before and after treatment were grouped by the best cut-off value or median, and the differences in progression-free survival and overall survival were analyzed by each index group. Results NLR and PLR in the remission group before each cycle of treatment were significantly lower than those in the non-remission group, and SII in the remission group before cycles 2nd, 3rd, and 4th of treatment were significantly lower than those in the non-remission group (P<0.05); From initial treatment to before the fourth treatment cycle,NLR and SII decline rates in the remission group were significantly higher than those in the non-remission group (P<0.05); the tumor stage, NLR before cycle 4th of treatment were independent influencing factors of short-term efficacy in patients with advanced NSCLC (P<0.05); patients with low NLR, PLR, SII and higher rates of decline in NLR and SII before cycle 4th treatment had longer progression-free survival and overall survival (P<0.05). Conclusion Tumor stage and post-treatment NLR are significantly correlated with the short-term outcomes of patients with advanced NSCLC, and high post-treatment NLR often suggests a poorer response to treatment. The prognosis of advanced NSCLC patients with higher NLR decline rate and higher SII decline rate after treatment is better. |
| keywords:Non-small cell lung cancer Short-term efficacy Neutrophil-to-lymphocyte ratio Platelet-to-lymphocyte ratio Systemic immune-inflammation index |
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