Correlation Between Peripheral Blood Inflammatory Indicators(SII、LMR) And Short-term Treatment Efficacy And Prognosis Of Small Cell Carcinoma Of The Lung

Objective :To investigate the correlation between the Systemic immune-inflammation index(SII)and Lymphocyte to monocyte ratio(LMR)before treatment and the short-term treatment efficacy and prognosis of small cell carcinoma lung cancer.Materials and methods :Patients with small cell lung cancer who received standardized sequential treatment at the Second Affiliated Hospital of Nanchang University from 02 2019 to01 2023 were collected from the first visit,and 100 eligible patients were included according to the inclusion criteria,including 70 patients receiving first-line chemotherapy and 30 patients receiving first-line chemotherapy combined with immunotherapy.Peripheral blood SII and LMR values were collected from patients within 1 week prior to cycle 1 treatment.The optimal cut-off values of SII and LMR were determined by the Receiver operating characteristic curve(ROC)based on median PFS,and the patients were grouped into high and low inflammation levels using this as the baseline level.The binary logistic regression analysis was applied to the objective remission rate(ORR)after the 2nd cycle of treatment and the one-way Kaplan-Meier survival curve to analyze the progression free survival(PFS)of patients.The independent prognostic factors affecting PFS in patients with small cell lung cancer were also analyzed by multifactorial COX proportional risk regression model.Log-rank comparison of the differences between groups,p < 0.05 indicated that the differences were statistically significant.Results :1.Analysis of objective remission rate(ORR)after the 2nd cycle of treatment using binary logistic regression analysis showed that SII was significantly associated with ORR in SCLC patients(p<0.05)with a risk ratio of 6.324(95% CI1.531-26.275;p<0.05)and was a risk factor for ORR,while age,gender,Ki67value-added index LMR,the initial tumour stage,treatment regimen and smoking history were not associated(p > 0.05).2.Kaplan-Meier survival curves for patients with progression free survival(PFS)showed that SII,LMR,initial tumour stage,treatment regimen and smoking history were significantly associated with median PFS in SCLC patients(all p < 0.05),with a significant correlation between high SII and low SII,high LMR and low LMR,limited stage and extensive stage,receiving first-line chemotherapy and receiving first-line chemotherapy combined with immunotherapy,and smoking and non-smoking.PFS was 109 vs 272 days,262 vs 161 days,278 vs 186 days,217 vs277 days and 207 vs 240 days in high versus low SII,high versus low LMR,limited versus extensive stage,receiving first-line chemotherapy versus receiving first-line chemotherapy in combination with immunization,and smoking versus non-smoking,respectively.Multi-factor COX analysis showed that: only initial tumour stage,SII,and treatment regimen were independent prognostic factors for median PFS in SCLC patients,with median PFS of 278 days in the limited stage and 186 days in the extensive stage,risk ratio 1.711(95% CI 1.047-2.794;p<0.05);217 days for those receiving first-line chemotherapy and combination immunotherapy group,with a risk ratio of 2.005(95% CI 1.167-3.444;p < 0.05);109 days for patients with high SII before treatment compar-ed to 272 days for those with low SII,with a risk ratio of8.074(95% CI 3.360-19.406;p < 0.001);and the analysis of smoking history and LMR did not show significant statistical differences(all p > 0.05).3.In addition,there were significant differences(p < 0.05)in PFS among patients with different levels of SII in the subgroups of SCLC patients with limited stage,extensive stage,receiving first-line chemotherapy,and receiving first-line chemothe-rapy combined with immunisation,with median PFS of 201 vs 285 days,109 vs 232 days,102 vs 236 days,and 132 vs 473 days,respectively.Conclusion :1.Pretreatment peripheral blood SII levels may be a predictor of short-term outcome and PFS in SCLC patients,and are expected to be an indicator of clinical outcome and prognosis in SCLC patients..2.Peripheral blood LMR levels before treatment were not significantly correlated with short-term outcome and PFS,and were not of predictive value.