血小板与淋巴细胞比值在表皮生长因子受体突变型非小细胞肺癌靶向治疗疗效与预后评价中的价值
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摘要
目的探讨血小板与淋巴细胞比值(PLR)在表皮生长因子受体(EGFR)突变型非小细胞肺癌(NSCLC)靶向治疗疗效与预后评价中的价值。方法选取EGFR突变型NSCLC患者90例,于靶向治疗前计算PLR,以其中位数为截点分组,分为A组(低PLR组)和B组(高PLR组)。患者均予以EGFR-TKIs治疗。分析PLR与NSCLC临床病理特征的关系,比较两组间客观疗效、ORR、DCR、PFS与OS的差异。结果治疗前,PLR中位数为139,A组(低PLR组,PLR≤139)44例,B组(高PLR组,PLR> 139)46例。A组与B组在是否吸烟、肿瘤部位、组织分化、T分期、临床分期比较,差异有统计学意义(P <0.05)。A组PR、ORR、DCR率高于B组,PD率低于B组(P <0.05)。A组中位OS、中位PFS均长于B组(P=0.001)。结论 PLR在EG-FR突变型NSCLC靶向治疗疗效与预后评价中具有一定的参考价值,低PLR的EGFR突变型NSCLC患者经靶向治疗后具有更高的疗效和更长的存活期,是独立的预后评估因素。
Objective To explore the value of PLR in peripheral blood in the efficacy and prognosis of targeted therapy for NSCLC with EGFR-mutated. Methods Ninety patients with EGFR-mutant of NSCLC were selected, and the PLR was calculated before targeted therapy. The PLR median was used as a cut-off point for grouping,and they were assigned to group A(low PLR group) and group B( high PLR group). All patients were treated with EGFR-TKIs. Relationship between PLR and clinicopathological features was analyzed. Objective efficacy, ORR,DCR, PFS and OS between the two groups were compared. Results Before EGFR-TKIs therapy, median PLR was 139,and there were 44 patients in group A, and 46 in group B. There were statistical differences regarding smoking, tumor location, histological differentiation, T staging, and clinical staging between group A and B(P <0.05). The rates of PR, ORR and DCR in group A were higher than those in group B, and the PD rate was lower than that in group B( P < 0.05). Log-rank test showed that median OS and median PFS in group A were longer than those in group B(P= 0.001). Conclusions PLR in peripheral blood has certain reference value for therapeutic effect and prognosis evaluation on NSCLC with EGFR-mutation. Low PLR of NSCLC patients with EGFR-mutation has higher efficacy and longer survival time after targeted therapy, and it is an independent and prognostic factor.
Objective To explore the value of PLR in peripheral blood in the efficacy and prognosis of targeted therapy for NSCLC with EGFR-mutated. Methods Ninety patients with EGFR-mutant of NSCLC were selected, and the PLR was calculated before targeted therapy. The PLR median was used as a cut-off point for grouping,and they were assigned to group A(low PLR group) and group B( high PLR group). All patients were treated with EGFR-TKIs. Relationship between PLR and clinicopathological features was analyzed. Objective efficacy, ORR,DCR, PFS and OS between the two groups were compared. Results Before EGFR-TKIs therapy, median PLR was 139,and there were 44 patients in group A, and 46 in group B. There were statistical differences regarding smoking, tumor location, histological differentiation, T staging, and clinical staging between group A and B(P <0.05). The rates of PR, ORR and DCR in group A were higher than those in group B, and the PD rate was lower than that in group B( P < 0.05). Log-rank test showed that median OS and median PFS in group A were longer than those in group B(P= 0.001). Conclusions PLR in peripheral blood has certain reference value for therapeutic effect and prognosis evaluation on NSCLC with EGFR-mutation. Low PLR of NSCLC patients with EGFR-mutation has higher efficacy and longer survival time after targeted therapy, and it is an independent and prognostic factor.
引文
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[2]NISHIKAWA S,KIMURA H,KOBA H,et al.Selective gene amplification to detect the T790M mutation in plasma from patients with advanced non-small cell lung cancer(NSCLC)who have developed epidermal growth factor receptor tyrosine kinase inhibitor(EGFR-TKI)resistance[J].J Thorac Dis,2018,10(3):1431-1439.
[3]刘光辉,方萍,赵家胜.血小板/淋巴细胞比值和2型糖尿病微血管病的相关性[J].实用医学杂志,2016,32(20):3306-3309.
[4]LAI Q,MELANDRO F,LARGHI LAUREIRO Z,et al.Plateletto-lymphocyte ratio in the setting of liver transplantation for hepatocellular cancer:A systematic review and meta-analysis[J].World J Gastroenterol,2018,24(15):1658-1665.
[5]潘莹,龚五星,梁翠微,等.晚期非小细胞肺癌靶向治疗进展后的临床研究[J].实用医学杂志,2016,32(3):437-439.
[6]周建英,周建娅.国际指南推荐的肺癌表皮生长因子受体基因突变和间变性淋巴瘤激酶基因重排检测及其临床进展[J].中华结核和呼吸杂志,2014,37(3):167-169.
[7]张永强,刘俊,陈胜阳,等.异丙酚影响基质金属蛋白酶对肺腺癌细胞株增殖侵袭能力的作用[J].实用医学杂志,2018,34(3):357-361.
[8]葛婷雯,崔久嵬.肿瘤与肿瘤炎症微环境相互促进机制研究进展[J].临床检验杂志,2017,35(11):832-835.
[9]MCCOACH C E,BIVONA T G.The evolving understanding of immunoediting and the clinical impact of immune escape[J].JThorac Dis,2018,10(3):1248-1252.
[10]LAI Q,MELANDRO F,LARGHI LAUREIRO Z,et al.Plateletto-lymphocyte ratio in the setting of liver transplantation for hepatocellular cancer:A systematic review and meta-analysis[J].World J Gastroenterol,2018,24(15):1658-1665.
[11]DUPRéA,MALIK H Z.Inflammation and cancer:What a surgical oncologist should know[J].Eur J Surg Oncol,2018,44(5):566-570.
[12]STOTZ M,LIEGL-ATZWANGER B,POSCH F,et al.Bloodbased biomarkers are associated with disease recurrence and survival in gastrointestinal stroma tumor patients after surgical resection[J].PLoS One,2016,11(7):48.
[13]JIANG Y,QU S,PAN X,et al.Prognostic value of neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio in intensity modulated radiation therapy for nasopharyngeal carcinoma[J].Oncotarget,2018,9(11):9992-10004.
[14]TODA M,TSUKIOKA T,IZUMI N,et al.Platelet-to-lymphocyte ratio predicts the prognosis of patients with non-small cell lung cancer treated with surgery and postoperative adjuvant chemotherapy[J].Thorac Cancer,2018,9(1):112-119.