The Relationship Between Fibrinogen,Neutrophil/lymphocyte Ratio,Platelet/lymphocyte Ratio And Chemotherapy Efficacy And Prognosis Of Lung Cancer

Objectives:To investigate the significance of peripheral blood fibrinogen,neutrophil/lymphocyte ratio,platelet/lymphocyte ratio and the dynamic changes of the latter two in chemotherapy efficacy and prognosis of patients with lung cancer Methods:The medical records of 61 patients with lung cancer who were regularly diagnosed and treated in the respiratory department of the First Hospital of Jilin University from January 2018 to December 2020 were analyzed retrospectively.The values of FIB,NLR0 and PLR0 at baseline,the levels of NLR2 and PLR2 after 2cycles of chemotherapy,the levels of NLR4 and PLR4 after 4 cycles of chemotherapy,the progress and survival status of patients were counted.Patients were divided into survival group(37 patients)and death group(24 patients),the receiver operating characteristic curve(ROC curve)was drawn,and the cut-off point with the maximum Joden-index(sensitivity+specificity-1)was selected to determine the best cutoff values of NLR,PLR and FIB.Based on this,continuous variables were transformed into two-category variables for patients to be divided into groups,and the clinical characteristics,curative effects and prognosis of patients in different groups were compared.SPSS25.0 software was used for statistical analysis to analyze the relationship between FIB,NLR,PLR and their dynamic changes and the clinical characteristics,therapeutic efficacy and prognosis of patients.Results:1.The optimal cutoff values of NLR0,NLR2,NLR4,PLR0,PLR2,PLR4 and FIB are 2.92,1.33,1.0,143.15,110.37,269.50 and 3.38,respectively.2.Patients were divided into two groups according to the optimal truncation value of NLR2 level after 2 cycles of chemotherapy(1.33),and NLR2 was correlated with efficacy evaluation after 4 cycles of chemotherapy,and the difference was statistically significant(P< 0.05),and patients with high NLR2 have a higher proportion of disease progression.NLR level was not correlated with gender,age,smoking history,stage,pathological type,and 2 cycles of chemotherapy efficacy,and the difference was not statistically significant.3.Patients were divided into groups according to the best cut-off value of PLR0(143.15).The baseline PLR0 before chemotherapy was correlated with smoking history(P < 0.05),and the difference was statistically significant.However,PLR was not related to the gender,age,stage,pathological type,and the evaluation results of2-cycle and 4-cycle chemotherapy.4.After grouping patients according to the best cut-off value of FIB of 3.88,it was found that the baseline level of FIB before chemotherapy was correlated with smoking history,and the difference was statistically significant(P < 0.05).However,FIB was not related to gender,age,stage,pathological type,evaluation results of2-cycle and 4-cycle chemotherapy,and there was no significant difference.5.In this study,it was found that after grouping 61 lung cancer patients according to their smoking history,the differences of FIB,NLR0 and PLR0 were statistically significant(P < 0.05).6.In this study,there is no statistically significant relationship between the dynamic changes of NLR and PLR and the curative effect of chemotherapy.7.According to Kaplan Meier univariate survival analysis of PFS,smoking history,staging of small cell lung cancer,evaluation results of 2-cycle and 4-cycle chemotherapy,FIB are related to progression-free survival of lung cancer patients(P< 0.05).COX multivariate analysis showed that the evaluation of curative effect after2 and 4 cycles of chemotherapy was an independent factor for the progress of lung cancer patients(P < 0.05).8.Kaplan Meier univariate survival analysis showed that the stage of small cell lung cancer,efficacy evaluation results of 4 cycles of chemotherapy,NLR4,PLR2,FIB and dynamic changes of NLR after 4 cycles of chemotherapy were related to the overall survival of lung cancer patients(P < 0.05).Cox multivariate analysis showed that NLR4,PLR2 and FIB were independent factors for the survival and prognosis of lung cancer patients(P < 0.05).Conclusion:1.Smoking can affect the levels of NLR,PLR and FIB.2.NLR2 is related to the evaluation of curative effect after 4 cycles of chemotherapy.Patients with high NLR2 have a higher proportion of disease progression,and peripheral blood NLR can be used to predict the curative effect of chemotherapy for lung cancer patients.3.NLR4,PLR2 and FIB are independent factors influencing the survival and prognosis of lung cancer patients.Among them,patients with a lower level of FIB have a higher survival rate.