摘要
Abstract
Objective:To explore the predictive value of blood routine parameters for the efficacy and adverse reactions of immune checkpoint inhibitors(ICIs)in the treatment of malignant tumors.Method:The clinical data of 104 patients with malignant tumors who received ICIs treatment at Xiamen Xinglin Hospital from January 2023 to January 2024 were collected.They were divided into the effective group(74 cases)and the ineffective group(30 cases)according to the treatment effect.According to whether immune-related adverse reactions(irAEs)occurred after treatment,they were divided into the irAEs group(49 cases)and the non-IRAES group(55 cases).The blood routine test results of each group before treatment were compared,and the relationship between blood routine parameters and the objective efficacy of ICIs treatment as well as irAEs was analyzed.Result:The blood routine parameters[white blood cell count(WBC),eosinophil(EOS),neutrophil count(NEUT),monocyte count(MONO),hemoglobin(Hb),red blood cell count(RBC),platelet count(PLT),ENT,neutrophil count/lymphocyte count(NLR)]levels before treatment in the effective group and the ineffective group were close,and the differences were not statistically significant(P>0.05).Compared with the ineffective group,the prothrombin time(PT)value of the effective group was lower,and the lymphocyte count(LYM)and lymphocyte count/monocyte count(LMR)values were higher,with statistically significant differences(P<0.05).Multivariate analysis showed that LYM and LMR were the influencing factors of the objective efficacy of ICIs,and the differences were statistically significant(P<0.05).PT was not an influencing factor of objective therapeutic effect,and the difference was not statistically significant(P>0.05).The levels of blood routine parameters[WBC,EOS,LYM,NEUT,MONO,HB,RBC,PLT,PT and NLR]before treatment in the irAEs group and the non-IRAES group were similar,and the differences were not statistically significant(P>0.05).The ENR value of the irAEs group was higher than that of the non-IRAES group,while the LMR value was lower than that of the non-IRAES group,and the difference was statistically significant(P<0.05).Multivariate analysis showed that ENR and LMR were the influencing factors of irAEs,and the differences were statistically significant(P<0.05).Conclusion:ICIs treatment can bring survival benefits to patients with malignant tumors.The blood routine parameters LYM and LMR before treatment can help predict the objective efficacy of ICIs in clinical practice,and ENR and LMR can help predict the occurrence of irAEs in clinical practice.关键词
恶性肿瘤/免疫检查点抑制剂/血常规/免疫相关不良反应/疗效/血液学Key words
Malignant tumors/Immune checkpoint inhibitors/Routine blood test/Immune related adverse reactions/Therapeutic effect/Hematology
