检验医学与临床2025，Vol.22Issue(10)：1343-1349,7.DOI:10.3969/j.issn.1672-9455.2025.10.010
治疗前血PLR、CAR、SII表达与局部晚期NSCLC新辅助免疫治疗应答的相关性分析
Correlation analysis between pretreatment blood PLR,CAR,and SII expression and response to neoadjuvant immunotherapy in locally advanced NSCLC
摘要
Abstract
Objective To investigate the correlation between platelet count(PLT)/lymphocyte count(LYM)ratio(PLR),C reactive protein(CRP)/albumin(ALB)ratio(CAR),systemic immune inflammation index(SII)and the response to neoadjuvant immunotherapy in locally advanced non-small cell lung cancer(NSCLC),and the predictive value of treatment response results as major pathological response(MPR).Methods The clinical data of 137 patients with locally advanced NSCLC who received neoadjuvant immuno-therapy and radical surgery in the hospital from January 2021 to June 2023 were retrospectively analyzed.The patients were divided into MPR group and non-MPR group according to the treatment response.The baseline data and serum PLR,CAR and SII before treatment were compared between the two groups.Multivariate Lo-gistic regression analysis was used to analyze the influencing factors of MPR in NSCLC patients with treat-ment response.The receiver operating characteristic(ROC)curve was used to analyze the predictive value of pretreatment serum PLR,CAR and SII for MPR in NSCLC patients.According to the optimal cut-off value of ROC curve analysis results,the PLR,CAR,and SII expression in patients were divided into high expression and low expression.The risk factors of non-MPR in patients with different serum PLR,CAR and SII level be-fore treatment were analyzed.Results A total of 84 patients(61.31％)developed MPR after the operation and were included in the MPR group,and fifty-three patients(38.69％)without MPR were included in the non-MPR group.There were significant differences in tumor stage and programmed death-1 ligand(PD-L1)expression between the non-MPR group and the MPR group(P＜0.05).The PLR,CAR and SII in the non-MPR group were higher than those in the MPR group before treatment and the differences were statistically significant(P＜0.05).Multivariate Logistic regression analysis showed that tumor stage ⅢB,strong positive PD-L1 expression,increased PLR,increased CAR and increased SII were protective factors for MPR in NSCLC patients(P＜0.05).After adjusting for tumor stage and PD-L1 expression,the results showed that increased PLR,increased CAR,and increased SII were still protective factors for MPR in NSCLC patients(P＜0.05).ROC curve analysis showed that the area under the curve(AUC)of pretreatment serum PLR,CAR and SII to predict the treatment response of NSCLC patients were 0.746,0.737 and 0.744 respectively.The AUC of combined detection of the three to predict the treatment response of NSCLC patients was 0.856,which was greater than the AUC of the three tests alone(Z=2.099,2.408,2.110,P=0.036,0.016,0.035).The risks of non-MPR in patients with pretreatment serum PLR,CAR and SII high expression were 5.165,4.476 and 4.397 times higher than those in patients with PLR,CAR and SII low expression respectively(P＜0.05).Conclusion The levels of PLR,CAR and SII before treatment are the influencing factors of the response to neoadjuvant immunotherapy in patients with locally advanced NSCLC.The combined detection of PLR,CAR and SII has a certain predictive value for the response to neoadjuvant immunotherapy,which can be used as an auxiliary indicator for early clinical prediction of treatment response and has certain guiding significance for clinical work.关键词
血小板计数/淋巴细胞计数比值/C反应蛋白/清蛋白比值/全身免疫炎症指数/非小细胞肺癌/局部晚期/新辅助免疫治疗/主要病理缓解/预测Key words
platelet count/lymphocyte count ratio/C reactive protein/albumin ratio/systemic immune inflammation index/non-small cell lung cancer/locally advanced/neoadjuvant immunotherapy/major pathological response/prediction分类
医药卫生引用本文复制引用
任伟东,史敏慧,荀玉芳,李飞,郭荣..治疗前血PLR、CAR、SII表达与局部晚期NSCLC新辅助免疫治疗应答的相关性分析[J].检验医学与临床,2025,22(10):1343-1349,7.基金项目
山西省科学技术研究与开发项目(202012D162042). （202012D162042）
