Correlational Between Inflammatory Markers And The T Efficacy Of Immunotherapy In Advanced Non-small Cell Lung Cancer

Objective1.To explore the relationship between the peripheral hematological biomarkers NLR,LMR,DNLR and SII and the clinical characteristics of patients with advanced non-small cell lung cancer receiving immunotherapy.2.To explore whether the peripheral hematological biomarkers NLR,LMR,DNLR and SII can play a role in predicting the efficacy of immunotherapy in advanced non-small cell lung cancer,and provide a basis for more accurate clinical selection of the immune benefit population.MethodsInformation on all inoperable locally advanced or advanced(stage IIIB-IV)lung cancer patients who were diagnosed with non-small cell lung cancer and treated with anti-PD-1/PD-L1 at Huaihe Hospital of Henan University from January 2018 to October 2022 was collected,and 127 patients with advanced nonsmall cell lung cancer treated with immunosuppressive therapy were selected for the study according to the inclusion and exclusion criteria by telephone,and The prognosis was followed up to December 2022,with a minimum follow-up time of 4 months,a maximum follow-up time of 60 months,and a median follow-up time of 10 months.The clinical and follow-up data of these 127 patients were uniformly entered using Microsof Access software to establish a database of patients with non-small cell lung cancer.The data were analyzed using SPSS(IBM SPSS 26.0,SPSS Inc.)software,and the descriptive analysis of the data was performed using frequencies and frequencies,and all data were expressed as medians,and the count data were expressed as n(%),and the best cut-off values of NLR,LMR,DNLR and SII were calculated by ROC curves and divided into high NLR and low NLR groups,high LMR and low LMR groups The differences between groups were analyzed by chi-squared test or Fisher’s exact probability method;the prognosis of patients with non-small cell lung cancer was analyzed by Log-Rank test for single-factor analysis and COX proportional risk model for multi-factor analysis,and Kaplan-Meier was used for survival analysis.The survival curves were plotted by the Kaplan-Meier method and the Log-Rank test was used.p<0.05 indicated that the differences were statistically significant.Results1.The optimal cut-off values for NLR,LMR,DNLR and SII were determined by ROC curves for predicting mortality in patients with non-small cell lung cancer,and the optimal cut-off values for NLR were determined as 3.365 [area under the curve(AUC)= 0.687(p=0.001)],LMR as 1.955 [area under the curve(AUC)= 0.653(p=0.007)],DNLR as 4.520 [area under the curve(AUC)= 0.708(p=0.000)],and 648.285[area under the curve(AUC)= 0.710(p=0.000)] for SII.2.The two groups of patients with high NLR and low NLR showed statistically significant differences in driver mutation status and number of metastatic organs(p<0.05).3.There were no statistically significant differences between the two groups of patients with high LMR and low LMR when comparing age,smoking status,gender,TNM stage,pathological type,distant metastasis,number of immunotherapy lines,PD-L1 expression level,driver mutation status,and number of metastatic organs.4.The differences between the two groups of patients with high DNLR and low DNLR were statistically significant in terms of driver mutation status and number of metastatic organs(p<0.05).5.The differences between the two groups of patients with high SII and low SII were statistically significant in terms of driver mutation status,number of metastatic organs,and number of immunotherapy lines(p<0.05).6.An increased level of serum inflammatory markers NLR,DNLR,SII and a decreased level of LMR were associated with significantly shorter progression-free survival(PFS)and overall survival(OS)in patients with non-small cell lung cancer(p<0.05).7.PFS in patients with non-small cell lung cancer was associated with driver mutation status,number of metastatic organs,number of immunotherapy lines,PD-L1 expression level,TNM stage,distant metastasis,pathology type,NLR level,LMR level,DNLR level and SII level,and all were independent prognostic influences on PFS in patients with non-small cell lung cancer.8.OS of non-small cell lung cancer patients was related to the number of metastatic organs,TNM stage,distant metastasis,pathological type,NLR level,LMR level,DNLR level and SII level,among which TNM stage,distant metastasis,pathological type,NLR level,LMR level,DNLR level and SII level were independent prognostic influences on OS of non-small cell lung cancer patients.Conclusions1.The driver mutation positivity rate and the number of metastatic organs ≥2 were significantly higher in the high NLR and DNLR groups than in the low NLR and DNLR groups;The rate of positive driver mutations,the rate of ≥2 metastatic organs,and the rate of receiving third-line or higher immunotherapy were significantly higher in the high SII group than in the low SII group;LMR levels were not significant in terms of clinical characteristics.2.Patients with non-small cell lung cancer in the low NLR,low DNLR,low SII and high LMR groups had better efficacy for immunotherapy.3.NLR,LMR,DNLR and SII were all influential factors for PFS and OS in non-small cell lung cancer patients,where high NLR,low LMR,high DNLR and high SII were risk factors for prognosis and low NLR,high LMR,low DNLR and low SII were protective factors for prognosis,and NLR,LMR,DNLR and SII were all independent influential factors for PFS and OS.