中国免疫学杂志2025，Vol.41Issue(7)：1593-1604,12.DOI:10.3969/j.issn.1000-484X.2025.07.009
炎症因子动态变化对铂类方案一线治疗晚期肺腺癌疗效的潜在评估价值
Potential value of dynamic changes of inflammatory factors in evaluating the efficacy of first-line treatment of advanced lung adenocarcinoma with platinum regimens
摘要
Abstract
Objective:To explore the potential value of dynamic changes of inflammatory factors in evaluating the efficacy of platinum regimen in the first-line treatment of advanced lung adenocarcinoma(LUAD).Methods:A total of 121 patients with advanced LUAD without common target mutations who were admitted to Dongtai People's Hospital to receive first-line treatment with platinum regimen from January 2021 to January 2023 were selected,and relevant clinical data such as general information,hematuria routine,angiogenic factors,serum tumor markers,inflammatory factors,immunoglobulin and T lymphocyte indexes were collected and statisti-cally analyzed.Patients in complete response(CR)group and partial response(PR)group were classified as chemotherapy sensitive group;stable(SD)group and progressive(PD)group were classified as chemotherapy insensitive group according to response evaluation criteria in solid tumors(RECIST).Through univariate and multi-factor Logistics regression analysis,the influencing factors of first-line treatment efficacy of platinum regimen in patients with advanced LUAD were analyzed,and the regression equation y=1-1/(1+e-z)prediction model was established and verified.Receiver operating characteristic(ROC)curve was used to analyze the potential value of dynamic changes of inflammatory factors in evaluating the efficacy of platinum-based first-line treatment for advanced LUAD.Results:①Univariate and multivariate Logistic regression analysis showed that CEA,TNF-α,IL-6,IL-8,IL-18,IL-1β and hs-CRP were still the influencing factors for the efficacy of first-line chemotherapy of platinum regimen in patients with advanced LUAD(P<0.05).②Inflammatory factors TNF-α,IL-6,IL-8,IL-18,IL-1β and hs-CRP were included in multivariate Logistic regression analysis.After correcting confounders(Model 5),high levels of TNF-α,IL-6,IL-8,IL-18,IL-1β and hs-CRP were positively correlated with insensitivity after first-line chemotherapy of platinum regimen in advanced LUAD patients(P<0.05).Restrictive cubic spline model analysis showed that the dynamic changes of inflammatory factors and the insensitivity of patients with advanced LUAD after first-line chemotherapy all had a nonlinear dose-response relationship.With the increases of TNF-α,IL-6,IL-8,IL-18,IL-1β and hs-CRP levels,patients with advanced LUAD have a greatly increased risk of desensitization after first-line chemotherapy.③Stratified interaction test analysis showed that tumor stage,differentiation degree and lymph node metastasis before and after correction factors were significantly correlated with expressions of inflammatory factors(all P<0.05,all P interaction<0.05).④Prediction model based on the influence factors of inflammatory factors was well distinguished and accurate,the area under ROC curve(AUC)before and after internal validation for detecting chemotherapy sensitivity in patients with advanced LUAD treated with platinum regimen first-line therapy was 0.87(95%CI:0.81～0.93)and 0.88(95%CI:0.82～0.95),respectively,and the sensitivity were 89.69%and 89.75%,respectively,the specificity were 91.77%and 91.85%,respectively.Conclusion:Dynamic changes of inflammatory factors is an important factor affecting the chemotherapy efficacy of patients with advanced LUAD treated with platinum-containing regimen.With the significant decrease of inflammatory factors,the sensitivity of patients to chemotherapy is also significantly increased.关键词
炎症因子/晚期LUAD/含铂化疗方案/疗效Key words
Inflammatory factors/Late LUAD/Platinum-containing chemotherapy regimen/Curative effect分类
医药卫生引用本文复制引用
高冬蕴,周雪峰,曹美华,孙婷,张霞..炎症因子动态变化对铂类方案一线治疗晚期肺腺癌疗效的潜在评估价值[J].中国免疫学杂志,2025,41(7):1593-1604,12.基金项目
2024年盐城市科技计划相关专项基金(YCBE202476) （YCBE202476）
盐城市卫健委2023年度医学科研立项(YK2023127). （YK2023127）
