LMR对广泛期小细胞肺癌一线化疗疗效和预后的预测价值

目的：探讨免疫炎症指标淋巴细胞-单核细胞比值(LMR)预测广泛期小细胞肺癌(ES-SCLC)病人一线化疗疗效和预后的价值。方法：回顾性收集符合本研究纳入标准的ES-SCLC病人临床资料，计算LMR,应用ROC曲线选择最佳截断值，分为高LMR组和低LMR组，分析2组一线化疗疗效、无进展生存时间(PFS)和总生存时间(OS)的差异。结果：共纳入50名ES-SCLC病人，临床特征分析提示，基线LMR与病人是否患有低蛋白血症和骨转移有关(P<0.05)。高、低LMR组客观缓解率分别为68.2%和35.7%,疾病控制率分别为90.9%和82.1%;基线LMR越高，化疗疗效越好(P<0.05)。高低2组中位PFS分别为9.0个月与5.8个月，中位OS分别为18.5个月与9.7个月。Cox回归分析提示，基线LMR是ES-SCLC病人一线治疗PFS和OS的独立预测因素(P<0.05～P<0.01)。结论：LMR有望成为评估ES-SCLC病人一线化疗应答和预后的新指标，低LMR病人的疗效和预后较差。

Value of LMR in predicting the efficacy of first-line chemotherapy and prognosis for extensive-stage small cell lung cancer

ObjectiveTo investigate the value of immune-inflammation index lymphocyte to monocyte ratio (LMR) in predicting the efficacy of first-line chemotherapy and also the prognosis in patients with extensive-stage small cell lung cancer (ES-SCLC).MethodsThe clinical data of ES-SCLC patients eligible for the inclusion criteria of this study were retrospectively collected.The LMR value were calculated, and the optimal cut-off value was selected based on receiver operating characteristic (ROC) curve.The patients were then divided into high- and low-LMR groups.The efficacy and progression-free survival (PFS) of first-line chemotherapy, and overall survival (OS) of patients in high- and low-LMR groups were finally analyzed.ResultsA total of 50 patients with ES-SCLC were included and divided into high- and low-LMR groups.Analyses of clinical characteristics showed that baseline LMR was associated with hypoproteinemia and bone metastasis(P < 0.05).The objective response rates were 68.2% and 35.7%, and the disease control rates were 90.9% and 82.1%, in patients in high- and low-LMR groups, respectively.Better efficacy of first-line chemotherapy can be achieved in patients with higher baseline LMR (P < 0.05).The median PFS in the high- and low-LMR groups were 9.0 and 5.8 months, and the median OS were 18.5 and 9.7 months, respectively.The Cox regression analyses results showed that LMR is an independent predictor of both PFS and OS in ES-SCLC patients treated with first-line chemotherapy(P < 0.05 to P < 0.01).ConclusionsLMR has the potential to sever as a new predictor of the treatment response of first-line chemotherapy and prognosis for patients with ES-SCLC, and the population with low LMR value tend to demonstrate poor efficacy and prognosis.