The Relationship Between NLR,PLR,FAR And Clinicopathologic Features Of Lung Cancer Patients And Their Clinical Value In Staging Of Non-small Cell Lung Cancer

Background:Lung cancer is one of the most common cancers worldwide,characterized by high incidence,late diagnosis,poor prognosis and high mortality.The relationship between chronic inflammation and lung cancer has been a research hotspot in recent years.Many studies have shown that neutrophil to lymphocyte ratio(NLR),platelet to lymphocyte ratio(PLR),fibrinogen to albumin ratio(FAR)and other indicators are of certain value in the diagnosis and prognosis of a variety of solid tumors,but there are few studies on their correlation with clinicopathologic characteristics of lung cancer patients.Objective:This study was aimed to investigate the relationship between NLR,PLR,FAR and clinicopathologic features of lung cancer patients and the clinical value of combined tumor markers in the staging of non-small cell lung cancer(NSCLC).Methods:A total of 205 patients who were diagnosed with lung cancer without any treatment in the First Hospital of Jilin University from July 2018 to September 2022 were selected.General data(age,gender,smoking history),laboratory tests(peripheral neutrophil count,peripheral lymphocyte count,peripheral platelet count,albumin value,fibrinogen value,carcinoembryonic antigen(CEA),carbohydrate antigen 125(CA125)),imaging examinations(lung,abdominal,craniocerebral CT,Whole body bone imaging or PET-CT),histopathologic type and genetic test results.Patients were clinically staged according to the TNM staging system of the eighth edition of the International Union Against Cancer(UICC),and NLR,PLR and FAR values were calculated based on the results of the above laboratory tests.In this study,SPSS26.0 software was used for data analysis.Firstly,the relationship between NLR,PLR,FAR and clinicopathologic features of lung cancer patients was comprehensively analyzed,and then the relationship between NLR,PLR,FAR and EGFR gene mutation in lung adenocarcinoma patients was further analyzed.Finally,NSCLC patients were divided into stage I-III and stage IV groups,and the levels of peripheral blood NLR,PLR,FAR and tumor markers CEA and CA125 were compared between the two groups.ROC curve was used to analyze the diagnostic efficacy of the above indexes in stage IV NSCLC alone and in combination.Results:1.The level of NLR in lung cancer patients with distant metastases was higher than that in lung cancer patients without distant metastases,and the level of NLR in lung cancer patients with serous cavity effusion was higher than that in lung cancer patients without serous cavity effusion,with statistical significance(P<0.05).There were significant differences in the level of NLR in lung cancer patients with different clinical stages(P<0.05).2.The PLR level of female lung cancer patients is higher than that of male lung cancer patients;the PLR level of non-smoking lung cancer patients is higher than that of smoking lung cancer patients;the PLR level of lung cancer patients with distant metastasis is higher than that of patients without distant metastasis;the PLR level of lung cancer patients with serous effusion is higher than that of patients without serous effusion.The above differences were statistically significant(P<0.05).There were significant differences in PLR levels in lung cancer patients with different clinical stages(P<0.05).3.The FAR level of lung cancer patients with smoking was higher than that of non-smoking lung cancer patients,and the FAR level of lung cancer patients with serous cavity effusion was higher than that of lung cancer patients without serous cavity effusion,the above differences were statistically significant(P<0.05).There were significant differences in the level of FAR among different clinical stages and different degrees of infiltration(P<0.05).4.There were statistically significant differences in peripheral blood NLR,PLR and tumor markers CEA and CA125 in patients with stage I-III and IV NSCLC(P<0.05),and the values were higher in patients with stage IV NSCLC.5.ROC curve was used to analyze the optimal cut-off values of each i ndex for the diagnosis of stage IV NSCLC patients,which were NLR 2.41,PLR 146.47,CEA 8.79ng/ml and CA125 23.91U/ml,respectively.The d iagnostic sensitivity was PLR(68.2%)>NLR(67.0%)>CA125(55.0%)>CE A(51.8%).The difference of diagnosis was CEA(90.6%)>CA125(75.6%)>PLR(60.5%)>NLR(57.0%).6.ROC curve was used to analyze the diagnostic value of different indexes combined with stage IV NSCLC patients.The results indicated that the combined AUC value of NLR+PLR+CEA+CA125 was the largest,which was 0.776,with the corresponding sensitivity of 68.8% and specificity of 76.9%.In terms of sensitivity,NLR+CEA combined with the highest,88.2%;In terms of specificity,NLR+CEA+CA125 was the highest(91.0%).Conclusions:1.The levels of NLR,PLR and FAR are related to the clinical characteristics of patients with lung cancer,and the increase of the above indexes has suggestive significance for the progression of lung cancer.2.The levels of NLR,PLR,CEA and CA125 in stage IV NSCLC patients are higher than those in stage I-III NSCLC patients,and the detection of peripheral blood NLR,PLR and tumor markers CEA and CA125 alone or combined with different indexes is of certain value for the clinical staging of patients with NSCLC.