| 李 新,毛 昀,王立凤,张 纯,张建伟,葛 捷.血清PNI，LMR，ALB/GLB与老年非小细胞肺癌患者治疗疗效及预后的关系研究[J].现代生物医学进展英文版,2024,(14):2699-2703. |
| 血清PNI，LMR，ALB/GLB与老年非小细胞肺癌患者治疗疗效及预后的关系研究 |
| Study on the Relationship between Serum PNI, LMR, ALB/GLB and Treatment Efficacy and Prognosis of Elderly Patients with Non-Small Cell Lung Cancer |
| Received:January 25, 2024 Revised:February 21, 2024 |
| DOI：10.13241/j.cnki.pmb.2024.14.018 |
| 中文关键词: 非小细胞肺癌 PNI LMR ALB/GLB 治疗疗效 预后 |
| 英文关键词: Non-small cell lung cancer PNI LMR ALB/GLB Treatment efficacy Prognosis |
| 基金项目:湖南省自然科学基金青年资助项目课题（2023JJ40497） |
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| 中文摘要: |
| 摘要 目的：探讨血清预后营养指数（PNI），淋巴细胞/单核细胞比值（LMR），白蛋白/球蛋白比值（ALB/GLB）与老年非小细胞肺癌（NSCLC）患者治疗疗效及预后的关系。方法：回顾性分析2021年1月至2023年1月我院收治的行程序性死亡受体-1（PD-1）抑制剂治疗的143例老年NSCLC患者，治疗前检测血清PNI，LMR，ALB/GLB，根据PNI，LMR，ALB/GLB均值将患者分为低PNI组和高PNI组，低LMR组和高LMR组，低ALB/GLB组和高ALB/GLB组。根据疗效分为疾病控制（DC）和客观缓解（OR），比较不同PNI，LMR，ALB/GLB水平疗效的差异。根据随访结果将老年NSCLC患者为生存组与死亡组。多因素COX回归分析影响老年NSCLC患者预后的因素，受试者工作特征（ROC）曲线分析PNI，LMR，ALB/GLB预测老年NSCLC患者预后不良的价值。结果：低PNI组、低LMR组、低ALB/GLB组DC率、OR率低于高PNI组、高LMR组、高ALB/GLB组（P＜0.05）。远处转移、低PNI、低LMR、低ALB/GLB是老年NSCLC患者预后不良的危险因素（P＜0.05）。PNI，LMR，ALB/GLB预测老年NSCLC患者预后不良的曲线下面积（AUC）分别为0.792、0.839、0.800，联合预测的AUC为0.931，高于单独指标预测。结论：低PNI，LMR，ALB/GLB水平与老年NSCLC患者PD-1抑制剂治疗效果欠佳和预后不良有关，联合PNI，LMR，ALB/GLB可有效预测老年NSCLC患者预后不良风险。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the relationship between serum prognostic nutritional index (PNI), lymphocyte/monocyte ratio(LMR), albumin/globulin ratio (ALB/GLB) and treatment efficacy and prognosis in elderly patients with non-small cell lung cancer (NSCLC). Methods: A total of 143 elderly patients with NSCLC who were treated with programmed death receptor-1 (PD-1) inhibitors in our hospital from January 2021 to January 2023 were retrospectively analyzed. Serum PNI, LMR and ALB/GLB were detected before treatment. According to the mean values of PNI, LMR and ALB/GLB, the patients were divided into low PNI group and high PNI group, low LMR group and high LMR group, low ALB/GLB group and high ALB/GLB group. According to the efficacy, they were divided into disease control(DC) and objective remission(OR), and the differences in efficacy of different PNI, LMR and ALB / GLB levels were compared. The elderly patients with NSCLC were divided into survival group and death group according to the follow-up results. Univariate and multivariate COX regression analysis were used to analyze the factors affecting the prognosis of elderly patients with NSCLC. The receiver operating characteristic(ROC) curve was used to analyze the value of PNI, LMR and ALB/GLB in predicting poor prognosis of elderly patients with NSCLC. Results: The DC rate and OR rate of low PNI group, low LMR group and low ALB / GLB group were lower than those of high PNI group, high LMR group and high ALB/GLB group(P<0.05). Distant metastasis, low PNI, low LMR and low ALB/GLB were risk factors for poor prognosis in elderly patients with NSCLC(P<0.05). The area under the curve(AUC) of PNI, LMR and ALB/GLB in predicting poor prognosis of elderly NSCLC patients were 0.792, 0.839 and 0.800, respectively. The AUC of combined prediction was 0.931, which was higher than that of single index prediction. Conclusion: Low levels of PNI, LMR and ALB/GLB are associated with poor treatment efficacy and poor prognosis of PD-1 inhibitors in elderly NSCLC patients. Combined PNI, LMR and ALB / GLB can effectively predict the risk of poor prognosis in elderly NSCLC patients. |
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