The Dynamic Changes Of NLR And PLR Are Related To The Hemotherapy Curative Effect And Prognosis Of Advanced Lung Adenocarcinoma

Objective This study aims to predict the Chemotherapy curative effect and survival of lung adenocarcinoma patients by using the dynamic changes of neutrophil to lymphocyte ratio(NLR)and platelet-to-lymphocyte ratio(PLR).Methods The medical records of 193 patients with advanced lung adenocarcinoma who were first diagnosed in the first affiliated hospital of bengbu medical college from 2012 to 2017 after first-line chemotherapy were retrospectively analyzed.Data before chemotherapy,2 cycles after chemotherapy and 4 cycles after chemotherapy were collected for evaluation of chemotherapy efficacy and NLR and PLR were calculated respectively.The relationship between dynamic changes of NLR and PLR,various clinical features,first-line chemotherapy efficacy and overall survival(OS)was analyzed.Statistical software SPSS21.0 was used for statistical analysis of relevant data.Results(1)NLR0(pre-treatment NLR)and pathological staging showed difference,high NLR0 ratio in the patients with pathological stage ? B significantly below its share of ? period,the difference was statistically significant(P = 0.042 < 0.05);The proportion of patients with high NLR0 in the distant metastasis group was significantly higher than that in the group without distant metastasis(P=0.031 <0.05).There was no significant difference between NLR0 and the patient's gender,age,lymph node metastasis,tumor location,smoking,and genetic testing(P>0.05).(2)In the analysis of PLR0(pre-treatment PLR)and clinical features,there was a statistical difference between height PLR0 and age(P=0.013 < 0.05).There was no significant difference between PLR0 and gender,pathological stage,lymph node metastasis,distant metastasis,tumor location,smoking,and gene detection(P>0.05).(3)Analysis on the efficacy of chemotherapy: in the non-parametric test,the level of NLR0,NLR2(NLR after 2 cycles of chemotherapy),PLR0 and PLR2(PLR after 2cycles of chemotherapy)of PD group(disease progression group)was higher than that of the corresponding disease control group(CR+PR+SD group)after 2-cycle chemotherapy(P<0.05).The levels of NLR0,NLR2,NLR4(NLR after 4 cycles of chemotherapy),PLR0,PLR2 and PLR4(PLR after 4 cycles of chemotherapy)in PD group were also higher than those in CR+PR+SD group(P<0.05).(4)In terms of survival:the total survival time of the high NLR0 group and the high NLR4 group was shorter than that of the low NLR0 group and the low NLR4 group,with statistical difference(P< 0.001).The total survival time of high PLR0 group was lower than that of PLR0 group.The total survival time of the high PLR2 group was lower than that of the low PLR2 group,and the difference was statistically significant(P< 0.001).The overall survival time of the high PLR4 group was significantly shorter than that of the low PLR4 group(P<0.001).NLR0,NLR4,PLR0,PLR2,PLR4,2-cycle chemotherapy efficacy and 4-cycle chemotherapy efficacy were significantly correlated with OS(P<0.05),and multivariate analysis showed that NLR0(P=0.045)and PLR4(P<0.001)were independent risk factors for survival.Conclusion High NLR and PLR are closely related to poor efficacy and survival of patients with advanced lung adenocarcinoma treated with first-line chemotherapy.NLR before treatment and PLR 4 weeks after chemotherapy are independent factors in predicting prognosis of patients with advanced lung adenocarcinoma treated with first-line chemotherapy.