| Background and purpose:This study investigated the relationship between Neut rophil-to-lymphocyte ratio（NLR）,Prognostic nutritional index（PNI）,Platelet-to-lymph ocyte ratio（PLR）,and Systemic immune-inflammation index（SII）and the efficacy and prognosis of patients with advanced non-small cell lung cancer（NSCLC）wh o treated with PD-1/PD-L1 inhibitors,It is used to screen out NSCLC patients who are more likely to benefit from PD-1/PD-L1 therapy.Methods: The clinical data of 80 patients with advanced NSCLC treated with PD-1/PD-L1 inhibitor who were treated with PD-1/PD-L1 inhibitor from September2018 to December 2021 in our hospital were retrospectively collected,including the age,gender,pathological type,tumor location,clinical stage,ECOG score,smoking history,number of metastatic sites,treatment drugs,etc.,as well as peripheral blood indicators 1week before receiving treatment,including peripheral blood serum albumin,neutrophil count,lymphocyte count,and platelet count,etc.According to the receiver operating characteristic（ROC）curve,find the maximum value of Youden index and use it to determine the best cut-off value of NLR,PLR,PNI and SII.According to the best cut-off value,the above indicators were divided into high NLR,high PLR,high PNI,high SII group and low NLR,low PLR,low PNI,low SII group.The short-term treatment efficacy of patients in the high and low groups was evaluated using RECIST version 1.1,and the differences in objective response rate（ORR）and disease control rate（DCR）between the high and low groups were compared using the χ2 test.Survival analysis was performed using the Kaplan-Meier method,and differences between high and low groups were compared using the log-rank test.Statistical analysis of all data was performed using SPSS 25.0 software.When P<0.05,the difference was statistically significant.Results: According to the ROC curve and AUC,the optimal cutoff values of NLR,PLR,PNI and SII were 4.63,126.60,44.77 and 856.14,respectively.NLR was divided into high NLR（NLR ≥4.63）group with 18 cases and low NLR（NLR <4.63）group with62 cases,and PLR was divided into high PLR（PLR ≥126.60）group with 54 cases and low PLR（PLR <126.60）group with 26 cases For example,PNI was divided into high PNI（PNI ≥44.77）group with 45 cases and low PNI（PNI <44.77）group with 35 cases,and SII was divided into high SII（SII ≥856.14）group with 33 cases and low PLR（PLR<856.14）Group of 47 cases.The χ2 test showed that the ORR of the high NLR group was 27.8%,and the ORR of the low NLR group was 30.2%,P=0.976,there was no significant difference between the high and low NLR groups,the DCR of the high NLR group was 61.1%,and the DCR of the low NLR group was 88.7 %,P=0.007<0.05,the difference between the high and low NLR groups was statistically significant;the ORR of the high PLR group was 29.6%,the ORR of the low PLR group was 26.9%,P=0.802,and the DCR of the high PLR group was 81.4%,the DCR in the low PLR group was88.5%,P=0.428,and there was no significant difference in the ORR and DCR between the high and low PLR groups;the ORR in the high PNI group was 29.7%,and the ORR in the low PNI group was 31.4%,P= 0.647,the DCR of the high PNI group was 84.4%,and the DCR of the low PNI group was 82.9%,P=0.849,there was no significant difference in ORR and DCR between the high and low PNI groups;the ORR of the high SII group was 33.3%,and the low SII group was 33.3%.The ORR of the group was25.5%,P=0.448,and there was no significant difference between the high and low SII groups.The DCR of the high SII group was 72.7%,and the DCR of the low SII group was 91.4%,P=0.025<0.05,the difference between the high and low SII groups was statistically significant.The results of survival analysis showed that the median PFS of the high NLR group was 6.4 months,the median PFS of the low NLR group was 9.4months,the difference between the two groups was statistically significant（P=0.031<0.05）.The median PFS of the high PLR group was 9.4 months,and the median PFS of the low PLR group was 8.3 months,and the median PFS of the low PLR group was14.9 months,there was no significant difference between the two groups（P=0.080>0.05）.The median PFS of the high PNI group was 12.7 months,and the median PFS of the low PNI group was 17.9 months,there was no significant difference between the two groups（P=0.063>0.05）.The median PFS of the high SII group was12.3 months,and the median PFS of the low SII group was 7.3 months,the difference between the two groups was statistically significant（P = 0.007 < 0.05）.Conclusion: For advanced NSCLC patients receiving immunosuppressive therapy,peripheral blood indicators NLR and SII can preliminarily predict the efficacy and prognosis of patients.They are convenient,economical,and fast,and provide help for clinical screening of the beneficiaries of immunotherapy. |
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