| Objective: The purpose of this experiment was to study the correlation of peripheral blood biomarkers and their dynamic changes with the efficacy and prognosis of immune checkpoint inhibitors(ICIs)in advanced non-small cell lung cancer(NSCLC).Methods: The electronic medical record system was used to collect 54 patients with stage IIIB-IV non-small cell lung cancer who were diagnosed with inoperable and inoperable stage IIIB-IV non-small cell lung cancer from 2019.9 to 2021.9 in the Department of Medical Oncology,People’s Hospital of Inner Mongolia Autonomous Region from 2019.9 to 2021.9.Clinical data,including gender,age,smoking,clinical stage,pathological type,ECOG score,and PD-L1 expression were detected by immunohistochemistry.Complete peripheral hematology-related indicators(peripheral neutrophil,lymphocyte,monocyte,platelet count and peripheral serum albumin concentration)of all patients with NSCLC included in this study were collected on the day of first visit or 1 week before immunotherapy and 2 cycles after treatment;The NLR,PLR,LMR and PNI were calculated from these indicators,and the indicators with good predictive ability for progression were screened out according to the receiver operating characteristic(ROC)curve and the area under the ROC curve(AUC),and the best cut-off value was determined.,according to the cut-off value,it was divided into two groups with high value and low value,and the treatment effect of patients with high value and low value was evaluated according to Response Evaluation Criteria in Solid Tumors(RECIST)version 1.1.Univariate analysis of survival was performed using the Kaplan-Meier method,differences between groups were compared using the log-rank test,and multivariate analysis was performed using a Cox proportional hazards regression model.All data were statistically analyzed using SPSS 26.0 software.P<0.05,the difference was statistically significant.Results: According to receiver operating characteristic(ROC)curve and area under the curve(AUC),the indicators with good predictive ability for progression are: NLR0,NLR2,PLR0,PLR2,PIN0;determine NLR0,NLR2,PLR0,PLR2,PIN0 The best cut-off values of 5.03(Se 0.833,Sp 0.729,AUC 0.774),5.028(Se 0.833,Sp 0.875,AUC 0.875),186.315(Se 0.833,Sp 0.729,AUC 0.764),155.355(Se 1,Sp 0.604),AUC 0.795),44.875(Se 0.833,Sp 0.750,AUC 0.814)divided NLR0 into H-NLR0(NLR0≥5.03)group with 18 cases and L-NLR0(NLR0<5.03)group with 36 cases,and NLR2 into H-NLR2 group(NLR2≥5.028)group 11 cases and L-NLR2(NLR2<5.028)group 43 cases,PLR0 divided into H-PLR0(PLR0≥186.315)group 18 cases and L-PLR0(PLR0 < 186.315)group 36 cases,PLR2 score There were 25 cases in the H-PLR2(PLR2≥155.355)group and 29 cases in the L-PLR2(PLR2<155.355)group.PNI0 was divided into the H-PNI0(PIN0≥44.875)group with 37 cases and the L-PNI0(PNI0<44.875)group with 17 cases.example.The results of Kaplan-Meier survival analysis showed that the median PFS of H-NLR0 group and L-NLR0 group were 3.9months and 6.9 months,respectively(P<0.05);the median PFS of H-NLR2 group and L-NLR2 group were 2.6 months and 6.8 months(P < 0.001);the median PFS of H-PLR0 group and L-PLR0 group were 3.5 months and 7.0 months(P < 0.05);the median PFS of H-PLR2 group and L-PLR2 group 4.0 months and 7.5 months respectively(P<0.05);the median PFS of H-PNI0 group and L-PNI0 group were 7.0months and 3.5 months respectively(P<0.05);the results of univariate analysis showed:NLR0,PLR0,PNI0,NLR2 and ECOG scores were correlated with PFS(P<0.05).Multivariate analysis showed that NLR2(HR=11.483,P<0.001)was an independent factor affecting the survival and prognosis of patients with advanced NSCLC after immunotherapy.Conclusion: Lower NLR0,PLR0,NLR2,and PLR2 and higher PNI0 were associated with better PFS,and NLR2 was an independent effect of PFS in patients with advanced non-small cell lung cancer using first-line immune checkpoint inhibitors in combination with standard platinum-based chemotherapy factor. |
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