摘要
Abstract
Objective:To explore the predictive value of combined evaluation of neutrophil to lymphocyte ratio(NLR),platelet to lymphocyte ratio(PLR),and lactate dehydrogenase(LDH)on the therapeutic effect and prognosis of ICIs(immune checkpoint inhibitors)in metastatic gastric cancer(MGC)patients.Methods:This study conducted a retrospective analysis of pre-and post-treatment peripheral hematological indicators of 88 MGC patients treated at Nanping First Hospital affiliated to Fujian Medical University.The recent treatment efficacy of the two patient groups was evaluated based on the solid tumor response evaluation criteria.χ2 tests were conducted to analyze and compare differences in disease control rate(DCR)and objective response rate(ORR),as well as differences in PD-L1 expression and clinical characteristics between the two groups.Survival analysis was performed using the Kaplan-Meier method for univariate analysis.Intergroup differences were detected by the Log-Rank test.Univariate analysis was conducted using the Cox proportional hazards regression model.Results:After immunotherapy,NLR3,NLR4,PLR2,PLR3,PLR4,LDH2 and LDH3 decreased significantly compared with those before treatment(all P<0.05).There were significant statistical differences in NLR1 and LDH1 before treatment between the complete-remission(CR)+partial-remission(PR)group and the progress-disease(PD)group(all P<0.05).Patients with higher levels of NLR2,NLR3,NLR4,PLR4,LDH1,LDH3,LDH4,ΔNLR1,ΔNLR2,ΔNLR3 and ΔPLR1 had shorter OS(all P<0.05),and patients with higher levels of NLR2,NLR3,NLR4,PLR1,LDH1,ΔNLR1,ΔNLR2,ΔNLR3,Δ PLR1 and Δ PLR2 had shorter PFS compared with patients in low-level group(all P<0.05).The percentage of PD-L1 negative patients among NLR3-H patients was the highest,and the number of NLR3-H patients in the NLR3-L group was larger than that in the negative group,the combined positive score(CPS)=1-5 group and the CPS≥5 group(all P<0.05).The proportion of women in the NLR3-H and PLR3-H groups was higher(all P<0.05).Conclusion:The evaluation of NLR,PLR,and LDH has certain value in predicting the efficacy and prognosis of immunotherapy for MGC.关键词
转移性胃癌/免疫治疗/中性粒细胞与淋巴细胞比值/血小板与淋巴细胞比值/乳酸脱氢酶/预后价值Key words
metastatic gastric cancer(MGC)/immunotherapy/neutrophil to lymphocyte ratio(NLR)/platelet to lymphocyte ratio(PLR)/lactate dehydrogenase(LDH)/prognostic value分类
临床医学
