Correlational Research On Pretreatment NLR、PLR With Clinical Features And Chemotherapy Efficacy In Stage Advanced Non-small Cell Lung Cancer Patients

Objective: We aimed to investigate the association between pretreatment NLR,PLR and clinical features(such as :gender,age,smoking status,ECOG score,pathological type),therapy response and progression free survival(PFS).Methods:76 cases who were hospitalized in Affiliated Hospital of Qinghai University between September 1st,2015 and July 31 st,2016,definitely diagnosed by pathological and the imaging examination with stage Ⅳ NSCLC were enrolled(6 of them out during the study).The basic information as: gender,age,smoking status,ECOG score,pathological type and blood routine indices(including Neutrophils,lymphocytes,platelet count)which were 24 h before the first chemotherapy was recorded for all the patients.Then treated the 70 patients with first-line platinum-based chemotherapy,21 days for one cycle,at least 2 cycles,after every 2 cycles,evaluated curative effect in accordance with RECIST 1.1.The deadline of follow-up was January 31 st,2017.At last,observed and recorded progression free survival of all.Statistical method: count datas described by frequency or rate,rate between groups compared by Chi-Square test;measurement datas described by (?) ±s,mean differences between groups compared by T test or variance analysis;Kaplan Meier method was applied for the survival curve and the difference tested by the log-rank.Cox regression analysis was adopted for PFS.A P value <0.05 was considered to be statistically significant.Results:1.70 patients in advanced NSCLC who enrolled,NLR level has nothing to do with gender,age,smoking status and pathological type.Patients between pretreatment NLR≥3.93 and NLR<3.93 of ECOG performance status 0-1(13.8% and 95.1%,respectively);after 2 cycles,patients of higher NLR level DCR was 72.4%,while lower 100.0%,P<0.001.2.70 patients in advanced NSCLC who enrolled,PLR level has nothing to do with gender,age,smoking status and pathological type.Patients between pretreatment PLR≥170and PLR<170 of ECOG performance status 0-1(22.6% and 92.3%,respectively);after 2 cycles,patients of higher PLR level DCR was 72.4%,while lower 100.0%,P<0.001.3.Single factor analysis: gender,age,smoking status,pathological type,chemotherapy regimens are not associated with PFS.While ECOG performance status,chemotherapy response after 2 cycles treatment,pretreatment NLR and PLR level are associated with prognosis of PFS of 70 patients in advanced NSCLC,P<0.001,respectively.4.COX multivariate analysis: chemotherapeutic effect after 2 cycles treatment(HR=0.086,P<0.001)and NLR level(HR=0.174,P<0.001)remained independent predictors of PFS in advanced NSCLC.5.Patients in advanced NSCLC who enrolled and treated >6 cycles mostly were low NLR,PLR level before treatment,ECOG performance status 0-1.Conclusions: 1.NLR,PLR level has nothing to do with gender,age,smoking status and pathological type.Patients of ECOG performance status 2 and PD after 2 cycles treatment were mostly in the groups of high NLR,PLR level.2.Poor chemotherapy response after 2 cycles treatment and elevated pretreatment NLR level might be independent biomarker of worse response to first-line platinum-based chemotherapy and shorter PFS for advanced NSCLC patients.But gender,age,smoking status,pathological type,chemotherapy regimens,ECOG performance status and PLR are not associated with prognosis of NSCLC.3.25 patients in advanced NSCLC who enrolled and treated >6 cycles mostly were low NLR,PLR level before treatment,ECOG performance status 0-1.