目的 探究免疫治疗前中性粒细胞/淋巴细胞比值(NLR)、血小板/淋巴细胞比值(PLR)与非小细胞肺癌患者预后转归和生存期限的关系.方法 选取 102 例行免疫治疗的非小细胞肺癌患者作为研究对象.免疫治疗结束后对所有患者进行为期 1 年的随访,根据随访结果分为存活组(45 例)和死亡组(57 例).比较 2 组患者的一般资料及免疫治疗前 NLR、PLR指标,使用受试者操作特征(ROC)曲线选取最佳截断值将患者进行分组,并比较患者生存情况的差异,采用 Cox风险比例回归模型分析影响非小细胞肺癌患者预后的因素.结果 2 组患者年龄、吸烟史、病理类型、病理分期、NLR、PLR等比较,差异有统计学意义(P<0.05).根据最佳截断值对非小细胞肺癌患者进行分组,低 NLR组患者 1 年累积生存率为 58.47%,高 NLR组患者 1 年累积生存率为 31.75%,低 NLR 组患者的1 年累积生存率高于高NLR组,差异有统计学意义(P<0.05);低PLR组患者 1 年累积生存率为 60.82%,高PLR组患者 1 年累积生存率为 34.26%,低 PLR组患者的 1 年累积生存率高于高 PLR 组,差异有统计学意义(P<0.05).多因素 Cox回归分析显示,年龄≥60 岁、病理分期Ⅳ期、NLR≥3.57、PLR≥168.42 为影响非小细胞肺癌患者预后的危险因素(P<0.05).结论 免疫治疗前 NLR、PLR水平与非小细胞肺癌患者的预后转归和生存期限具有一定相关性,NLR、PLR水平越高,患者预后越差,生存期限越短.
Objective To investigate the association of NLR and PLR before immunotherapy with prognostic regression and survival duration in patients with non-small cell lung cancer.Methods 102 pa-tients with non-small cell lung cancer who received immunotherapy were selected for the study.All pa-tients were followed up for a period of 1 year after the end of immunotherapy and were divided into a sur-vival group(45 patients)and a death group(57 patients)based on the results of the follow-up.We compared the general data and the NLR and PLR indexes of the 2 groups of patients before immunotherapy,grouped the patients using the ROC curve to select the best cutoff value,compared the differences in sur-vival,and analyzed the factors affecting the prognosis of patients with non-small-cell lung cancer using the Cox risk-proportional regression model.Results There were significant differences between the sur-vival group and the death group in terms of age,smoking history,pathological type,pathological stage,NLR,PLR,etc.(P<0.05).Grouping non-small cell lung cancer patients according to the optimal cut-off value,the 1-year cumulative survival rate of patients in the low NLR group was 58.47%,and that of patients in the high NLR group was 31.75%;the 1-year cumulative survival rate of patients in the low NLR group was higher than that of patients in the high NLR group,and the difference was statistically significant(P<0.05).The 1-year cumulative survival rate was 60.82%for patients in the low PLR group and 34.26%for patients in the high PLR group,and the 1-year cumulative survival rate of patients in the low PLR group was higher than that of the high PLR group(P<0.05).Multifactorial Cox regres-sion analysis showed that age≥60 years,pathological stage IV,NLR≥3.57,and PLR≥168.42 were the risk factors affecting the prognosis of patients with non-small cell lung cancer,and the difference was statistically significant(P<0.05).Conclusion The levels of NLR and PLR before immunotherapy are correlated with the prognosis and survival time of patients with non-small cell lung cancer.The higher the levels of NLR and PLR,the poorer the prognosis and the shorter the survival duration.