Relationship Between Systemic Inflammatory Response Makers And Radio-chemotherapy Efficacy And Prognosis Of Advanced Non-small Cell Lung Cancer

Background: Lung cancer is a malignant tumor with the highest incidence and mortality in worldwide,accounting for more than 25% of all cancer-related deaths.It is a major public health problem threatening human health.Primary lung cancer is generally divided into two main histopathological types: small cell lung cancer(SCLC)and non-small cell lung cancer(NSCLC).Of all lung cancers,non-small lung cancer(NSCLC)accounts for 85%,with majority of patients initially diagnosed at advanced stage.The 5-year overall survival rate(OS)is only between 15% and 35.9%.TNM stage is widely used in clinical tumor prognosis evaluation system,but due to the large heterogeneity of advanced NSCLC,the prognosis of patients with the same stage and the same treatment mode may vary greatly.Reliable prognostic indicators are essential for pre-treatment risk assessment and selection of appropriate treatment models.Neutrophil-lymphocyte ratio(NLR),lymphocyte-monocyte ratio(LMR),platelet-lymphocyte ratio(PLR),platelet combined with LMR(COP-LMR)is a series of parameters based on systemic inflammatory reaction.With the advantages of convenient detection,small trauma,low cost and high repeatability,it is expected to be a new prognostic indicator of cancer.This article will retrospectively analyze the relationship between pre-treatment LMR,NLR,PLR,COP-LMR and the prognosis of advanced NSCLC patients,and guide the clinical development of a more reasonable and effective treatment plan by early assessment of adverse prognostic factors.Aims: To analyze the relationship between the prognosis of patients with advanced NSCLC and LMR,NLR,PLR,COP-LMR before treatment.It can help us to find the related factors of poor prognosis,which can guide the clinical assessment as soon as possible.It's also provide a way to make more reasonable and individualized treatment schemes.Methods: To collect 97 NSCLC patients who were diagnosed by pathology in The Affiliated Hospital of QingDao University from January 2010 to December 2012.We also collect those patients' relevant clinical data(age,sex,smoking status,pathological type,clinical stage,etc.)and blood routine which was collected within 1 week before treatment.The survival of the patient was obtained by telephone follow-up and check-up of the patient's previous medical records.To analyze the relationship between pre-treatment LMR,NLR,PLR,COP-LMR and prognosis of advanced NSCLC patients.We was used SPSS 22.0 statistical software to analyze the data,chi-square or Fisher test was used to test the disordered variables,Kaplan-Meier method was used to analyze the single factor prognosis and drawn the survival curve.And the Cox proportional hazard regression model was used in the multivariate prognostic analysis.All the parameters were significantly different when P < 0.05.Results:1.ORR of the high LMR group was significantly higher than that of the low LMR group(81.13% vs.56.52%,P<0.05).ORR of the low NLR group was higher than that in the high NLR group,but there was no statistical difference(81.25% vs.60.71%,P=0.05).ORR of the low PLR group was also significantly higher than that of the high PLR group(82.61% vs.60%,P<0.05).In COP-LMR,there were significant differences in ORR and DCR(P<0.05).2.When the pathological type was adenocarcinoma,the median OS was longer than other types(25 months vs17.5 months,P<0.05).Higher PLR,NLR and lower LMR were correlated with shorter PFS and OS,and the difference was statistically significant(P<0.05).The COP-LMR score of 2 was significantly lower than that of 0(median OS was 16 months and vs29 months),and the difference was statistically significant(P<0.05).PFS and OS were not related to gender,age,smoking status,pathological differentiation degree,clinical stage,and whether or not to receive radiotherapy,and the difference was not statistically significant(P>0.05).3.Patients with adenocarcinoma had longer OS than patients with squamous cell carcinoma,and the difference was statistically significant.Patients in the high LMR group had longer PFS and OS than those in the low LMR group,and the difference was statistically significant.Patients in the low NLR group showed longer PFS than those in the high NLR group,while the difference in OS was not statistically significant.OS of patients in the low PLR group was longer than those in the high PLR group,but the PFS difference was not statistically significant.Compared with patients with COP-LMR value of 0,the patients with COP-LMR value of 2 extended,and the difference was statistically significant.Therefore,pathological types,LMR,PLR and COP-LMR are independent risk factors affecting the prognosis of patients.Conclusions:1.LMR,PLR,COP-LMR was associated with the efficacy of radiotherapy and chemotherapy in advanced NSCLC.2.Histological type,LMR,PLR and COP-LMR are independent risk factors for the prognosis of patients with advanced NSCLC.