| 王韵涵,郑晓丽,孙亚楠,等.肺免疫预后指数与局部晚期非小细胞肺癌放化疗预后的关系[J].中华放射医学与防护杂志,2022,42(7):504-510.Wang Yunhan,Zheng Xiaoli,Sun Yanan,et al.Relationship between lung immune prognostic and the prognosis of locally advanced non-small cell lung cancer treated with radiochemotherapy[J].Chin J Radiol Med Prot,2022,42(7):504-510 |
| 肺免疫预后指数与局部晚期非小细胞肺癌放化疗预后的关系 |
| Relationship between lung immune prognostic and the prognosis of locally advanced non-small cell lung cancer treated with radiochemotherapy |
| 投稿时间：2022-01-19 |
| DOI：10.3760/cma.j.cn112271-20220119-00027 |
| 中文关键词: 局部晚期非小细胞肺癌 放化疗 预后指标 肺的免疫预后指数 |
| 英文关键词:Locally advanced non-small cell lung cancer Radiochemotherapy Prognostic indicator Lung immune prognostic index |
| 基金项目: |
| 作者 | 单位 | E-mail | | 王韵涵 | 郑州大学附属肿瘤医院 河南省肿瘤医院放疗科, 郑州 450008 | | | 郑晓丽 | 郑州大学附属肿瘤医院 河南省肿瘤医院放疗科, 郑州 450008 | | | 孙亚楠 | 郑州大学附属肿瘤医院 河南省肿瘤医院放疗科, 郑州 450008 | | | 王晓辉 | 郑州大学附属肿瘤医院 河南省肿瘤医院放疗科, 郑州 450008 | | | 罗辉 | 郑州大学附属肿瘤医院 河南省肿瘤医院放疗科, 郑州 450008 | | | 程宸 | 郑州大学附属肿瘤医院 河南省肿瘤医院对外交流部, 郑州 450008 | | | 杨洋 | 郑州大学附属肿瘤医院 河南省肿瘤医院放疗科, 郑州 450008 | | | 但勤富 | 郑州大学附属肿瘤医院 河南省肿瘤医院放疗科, 郑州 450008 | | | 叶柯 | 郑州大学附属肿瘤医院 河南省肿瘤医院放疗科, 郑州 450008 | | | 葛红 | 郑州大学附属肿瘤医院 河南省肿瘤医院放疗科, 郑州 450008 | gehong666@126.com |
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| 中文摘要: |
| 目的 探讨肺免疫预后指数(LIPI)与局部晚期非小细胞肺癌(LA-NSCLC)放化疗预后的关系。方法 回顾性分析2013—2019年在郑州大学附属肿瘤医院行放化疗的LA-NSCLC患者临床资料。根据血液学衍生粒淋比(dNLR)和乳酸脱氢酶(LDH)检测结果,对患者进行LIPI评分,dNLR≤3及LDH≤正常值上限(ULN)为LIPI优组,dNLR＞3或LDH＞ULN为LIPI良组,dNLR＞3及LDH＞ULN为差组。采用Kaplan-Meier法、Log-rank法及Cox回归计算总生存(OS)及无进展生存(PFS)率。结果 共入组238例患者,中位随访时间37.1个月,全组中位PFS 16.1个月,中位OS 30.6个月。LIPI差组与优组、良组相比,OS及PFS较低(χ2=9.04、2.88,P＜0.05)。单因素分析结果显示,影响OS的因素包括性别、病理类型、表皮生长因子受体(EGFR)突变和LIPI分组(χ2=6.10、13.66、10.58、9.04,P＜0.05)。仅LIPI分组是可影响PFS的因素(χ2=2.88,P=0.03)。多因素分析提示,EGFR突变及LIPI各分组与患者OS具有独立相关性(HR=1.31、1.36;95%CI:1.03~1.67、1.05~1.76;P＜0.05)。结论 LIPI是LA-NSCLC放化疗的潜在预后指标,但仍需前瞻性研究进一步证实。 |
| 英文摘要: |
| Objective To investigate the relationship between lung immune prognostic index (LIPI) and the prognosis of locally advanced non-small cell lung cancer (LA-NSCLC) treated with radiochemotherapy. Methods A retrospective analysis was conducted for the clinical data of LA-NSCLC patients who received radiochemotherapy in the Affiliated Cancer Hospital of Zhengzhou University from 2013 to 2019. According to the hematologic test result of the derived neutrophil-to-lymphocyte ratio (dNLR) and the lactate dehydrogenase (LDH), the patients were divided into three groups according to their LIPI scores, namely the good-LIPI group with dNLR ≤ 3 and LDH ≤ upper limit of normal (ULN), moderate-LIPI group with dNLR >3 or LDH > ULN, and poor-LIPI group with dNLR >3 and LDH > ULN. Moreover, the overall survival (OS) and the progression-free survival (PFS) were calculated using the Kaplan-Meier method, the Log-rank test, and the Cox regression model. Results A total of 238 patients were enrolled, and their median follow-up time was 37.1 months, median PFS 16.1 months, and median OS 30.6 months. The OS and PFS of the poor-LIPI group were significantly worse than those of the good- and moderate- LIPI groups (χ2= 9.04, 2.88, P＜0.05). The univariate analysis showed that the factors influencing OS included gender, pathological type, epidermal growth factor receptor (EGFR) mutations, and LIPI (χ2=6.10, 13.66, 10.58, 9.04, P＜0.05), and the PFS was only affected by the LIPI (χ2=2.88, P= 0.03). Multivariate analysis suggested that EGFR mutations and LIPI were independent prognostic markers for OS (HR= 1.31, 1.36; 95% CI: 1.03-1.67, 1.05-1.76; P＜0.05). Conclusions The LIPI is a potential prognostic indicator of radiochemotherapy in LA-NSCLC, and this result should be further confirmed by prospective studies. |
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