| Objective:Through the analysis of 298 cases of advanced(ⅢB ～ Ⅳ)non-small cell lung cancer(NSCLC)in patients with clinical data,including gender,age,pathological type,TNM staging,body mass index(BMI),karnofsky performance score(KPS score),smoking history,treatment and hematological indicators(routine blood,blood biochemistry)before they were treated,to study the relationship between the neutrophil to lymphocyte ratio(NLR),platelet to lymphocyte ratio(PLR),system immune-inflammation index(SII),advanced lung cancer inflammation index(ALI)and overall survival of advanced non-small cell lung cancer,in order to evaluate prognosis earlier and provide more valuable treatment of patients.Methods:From October 2013 to December 2018,298 cases of advanced NSCLC patients were selected strictly in accordance with the inclusion criteria and exclusion criteria who were diagnosed at our hospital,collected their clinical data and according to the collection of peripheral blood cell counted NLR,PLR,SII,ALI.All the patients were followed-up by accessing to the electronic medical records and making a phone call,etc.Patients with confirmed date as a starting point,the end of follow-up time was the patients who were confirmed dead or follow-up deadline in June 2019,the shortest time of follow-up was 6 months,the median follow-up time was 26 months,this commencement date is the survival time(in month)of patients.The receiver operating characteristic(ROC)curves were drawn to determine the optimal cut-off values of NLR,PLR,SII,ALI.The patients with advanced NSCLC were divided into two groups to investigate the relationship with prognosis according to the optimal cut-off values;Wilcoxon rank sum test or Kruskal-Wallis H test were used to compare the difference of OS between different groups;The survival curves of patients with different characteristics were produced by Kaplan-Meier method.Survival rates were compared using log-rank method;χ2 test comparing the different clinical characteristics between different inflammatory biomarkers;The univariate and multivariate prognostic analysis were performed by the Cox proportional hazards model.P<0.05 was considered to represent a statistical difference.Results:1、This study included 298 patients with advanced NSCLC,the median OS(m OS)was 16 months,and pathological type,TNM staging,BMI,KPS score,smoking history,hemoglobin(HGB)levels,treatment method,NLR levels,PLR levels,SII levels,ALI levels median overall survival compared differences between groups were statistically significant(P<0.05).Full set of patients 6 months(6m),1 year(1a),2 years(2a)survival rates were 82.21%,59.06% and 20.47% respectively,and pathological type,TNM staging,BMI,KPS score,smoking history,HGB levels,treatment method,NLR levels,PLR levels,SII levels,ALI levels survival rates compared differences between groups were statistically significant(P<0.05).2、According to the ROC curves to determine the optimal cut-off point values of NLR,PLR,SII and ALI were 3.50,183.03,1016.64×109 and 339.37.Through χ2 test analysis concluded that TNM staging,BMI,KPS score and HGB level were associated with NLR,low NLR group was most of patients with stage ⅢB,high BMI,KPS score≥80 and without anemia;BMI,KPS score and HGB level were associated with PLR,low PLR group was most of patients with high BMI,KPS score≥80 and without anemia;KPS score and HGB level were associated with SII,low SII group was most of patients with KPS score≥80 and without anemia;BMI,KPS score and HGB level were associated with ALI,high ALI group was most of patients with high BMI,KPS score≥80 and without anemia.3、Univariate prognostic analysis shown that pathological type,TNM staging,BMI,KPS score,smoking history,level of HGB,treatment methods,and NLR,PLR,SII,ALI levels were associated with the prognosis of patients with advanced NSCLC(P<0.05).4、Multivariate prognostic analysis shown that pathological type,TNM staging,KPS score,smoking history,treatment methods and SII,ALI level were the independent risk factors influencing the prognosis of patients with advanced NSCLC(P<0.05).Conclusion:1、Pathological type,TNM staging,BMI,KPS score,smoking history,level of HGB,treatment methods,NLR,PLR,SII and ALI levels were associated with advanced NSCLC prognosis,including pathological type,TNM staging,KPS score,smoking history,treatment method and levels of SII,ALI were independent factors affecting prognosis of advanced NSCLC.2、Low NLR group was most of patients with stage ⅢB,high BMI,KPS score≥80 and without anemia;Low PLR group was most of patients with high BMI,KPS score≥80 and without anemia;Low SII group was most of patients with KPS score≥80 and without anemia;High ALI group was most of patients with high BMI,KPS score≥80 and without anemia.NLR,PLR,SII,ALI results were easy to obtain,and can be repeated inspection,so they can be used as evaluation indicators of patients with advanced NSCLC effective,low NLR,PLR,SII and high ALI were associated with good prognosis. |
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