The Prognostic Value Of SII/ALB In EGFR Mutant Advanced Non-small Cell Lung Cancer Treated With EGFR-TKI

Background and Objective: Advanced non-small cell lung cancer has developed rapidly and lost the chance of radical operation.Only relying on traditional treatment methods such as radiotherapy and chemotherapy,the 5-year survival rate of this part of patients is very low and the quality of life is poor.EGFR-TKI can improve the prognosis of advanced non-small cell lung cancer patients with EGFR gene sensitive mutations.A lot of research on the prognostic factors of EGFR-TKI in patients with advanced non-small cell lung cancer is going on.Nutritional status,inflammatory response,and Immune status have all been shown to be associated with the prognosis of non-small cell lung cancer treated with EGFR-TKI,and the three have been closely correlated with each other.Systemic immune-inflammation Index/Albumin(SII/ALB),which combines nutritional status,inflammatory response,and Immune status,has been shown to predict the prognosis of patients with small-cell lung cancer.And this mark may be used to evaluate the potential prognosis of patients with EGFR-TKI for EGFR-sensitive advanced non-small cell lung cancer before treatment.So far,there have been no studies on the prognosis of patients with EGFR-sensitive mutant advanced non-small cell lung cancer treated with EGFR-TKI using SII/ALB.We used a retrospective study to explore the effect of SII/ALB on progression free in patients with advanced non-small cell lung cancer who were initially diagnosed as EGFR sensitive mutations In order to provide a reference for clinical diagnosis and treatment,the effect of SII/ALB on EGFR sensitive mutation in advanced non-small cell lung cancer patients was further analyzed.Methods: From June 12,2013 to June 31,2017,73 patients with advanced non-small cell lung cancer diagnosed with EGFR sensitive mutation in Qingdao Municipal Hospital of Shandong Province were collected.All patients had received 1-2cycles of platinum containing chemotherapy before taking EGFR-TKI.At the end of follow-up,71 patients who met the criteria were divided into high SII/ALB group and low SII/ALB group according to the median.The PFS curves of the two groups were compared by kaplan-meier and the differences in PFS between the two groups were analyzed by log-rank test.The related factors of PFS were analyzed by single factor and multi factor variables in Cox regression,P <0.05 was statistically significant.Results: 1.SII/ALB was correlated with age(P=0.012),tumor stage(P=0.000),albumin(P=0.000),HGB(P=0.024),lactate dehydrogenase(P=0.011),carcinoembryonic antigen(P=0.000),neutrophil count(P=0.009),lymphoid cell count(P=0.038),monocyte count(P=0.043),platelet count(P=0.000).2.The median progression-free survival(mPFS)of patients in the high SII/ALB group was 9.2 months,patients' mPFS was 14.5 months in another group.The kaplan-meier method showed that the PFS of patients in the low SII/ALB group was significantly superior to those in the high SII/ALB group(log-rank P<0.001).3.Cox single factor regression analysis indicated that patients gender,tumor stage,serum albumin before treatment,lactate dehydrogenase,carcinoembryonic antigen,peripheral blood neutrophil count,lymphocyte count,platelet count and SII/ALB levels had statistical significance for PFS(P<0.05).Single factor analysis was used to screen out the PFS variables of EGFR sensitive mutant advanced non-small cell lung cancer patients treated with EGFR-TKI,which were statistically significant.Cox multivariate regression analysis showed tumor staging(HR=4.124,95%Ci : 1.593-10.675;P=0.004),oncoembryonic antigen(HR=0.272,95%Ci :0.119-0.620;P=0.002),peripheral blood lymphocyte count(HR=0.565,95%Ci:0.290-0.744;P=0.000)and SII/ALB(HR=2.472,95%Ci:1.055-5.788;P=0.037)were independent factors which affecting PFS in patients with EGFR-TKI treated with EGFR-sensitive mutant advanced non-small cell lung cancer.Conclusions: 1.SII/ALB can be used to predict the prognosis of EGFR-TKI in the treatment of EGFR mutant advanced non-small cell lung cancer.2.Tumor stage,serum oncoembryonic antigen level,lymphocyte count and SII/ALB were independent factors affecting the prognosis of patients receiving EGFR-TKI for advanced non-small cell lung cancer.