中性粒细胞/淋巴细胞CD4<sup>+</sup>/CD8<sup>+</sup>与PD-1抑制剂免疫治疗肺癌疗效及OS的关系研究

doi:10.3969/j.issn.1006-6233.2024.09.013

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Abstract Objective: To observe the changes in neutrophil/lymphocyte ratio (NLR) and CD4⁺/CD8⁺ in patients with lung cancer after treatment with programmed death receptor-1 (PD-1) inhibitor, and to analyze the correlation between changes of two indicators and efficacy and overall survival time (OS).Methods: A total of 94 patients with pulmonary cancer were included in the hospital from December 2019 to March 2022. The changes of NLR and CD4⁺/CD8⁺ were observed among patients with different efficacies after PD-1 treatment, and the association with different efficacies after immunotherapy and OS after 2 years of follow-up was analyzed.Results: There were statistically significant differences in NLR and CD4⁺/CD8⁺ among patients with different efficacies after PD-1 inhibitor treatment (P<0.05). The NLR and CD4⁺/CD8⁺ in the CR group and PR group were statistically different from those in the SD group and CD group (P<0.05), and there was a statistical significance in NLR between the SD group and PD group (P<0.05). Univariate analysis showed that the pathological type, TNM staging, differentiation degree, age, NLR and CD4⁺/CD8⁺ were statistically significant between the effective group and the ineffective group after immunotherapy (P<0.05). Logistic regression model found that small cell type, TNM staging (stage IV), differentiation degree (low differentiation), older age, and high NLR were risk factors for poor efficacy of immunotherapy (P<0.05), while high CD4⁺/CD8⁺ was a protective factor for poor efficacy of immunotherapy (P<0.05). ROC curve showed that the areas under the curves (AUCs) of NLR and CD4⁺/CD8⁺ in evaluating the efficacy were 0.785 and 0.777 respectively, and the AUC of NLR combined with CD4⁺/CD8⁺ was 0.871, which was significantly higher than that of single index (P<0.05). Spearman correlation analysis suggested that NLR was negatively correlated with OS (r=-0.341, P<0.05), and CD4⁺/CD8⁺ was positively correlated with OS (r=0.323, P<0.05).Conclusion: The NLR is lower while the CD4⁺/CD8⁺ is higher among patients with pulmonary cancer who are with effective PD-1 inhibitor treatment, and the two indexes have certain evaluated values on the efficacy of immunotherapy and also have a certain association with OS.

Key words： Lung cancer T lymphocytes Neutrophil-to-lymphocyte ratio Programmed death receptor-1

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http://www.hbyxzzs.cn/EN/10.3969/j.issn.1006-6233.2024.09.013 OR http://www.hbyxzzs.cn/EN/Y2024/V30/I9/1483

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