Effect of dNLR and LIPI scores on the prognosis of elderly patients with non-surgical treatment of non-small cell lung cancer.
10.3760/cma.j.cn112152-20200423-00371
- Author:
Jiang Hua XIE
1
;
Miao Miao LIU
2
;
Ning Ning SUN
1
;
Li ZHANG
1
;
Hong Zhen ZHANG
2
Author Information
1. Graduate College, North China University of Science and Technology, Tangshan 063210, China.
2. The Fifth Department of Oncology, Hebei General Hospital, Shijiazhuang 050051, China.
- Publication Type:Journal Article
- Keywords:
Derived neutrophil to lymphocyte ratio;
Elderly;
Lung immune prognostic index;
Lung neoplasms;
Prognosis
- MeSH:
Aged;
Carcinoma, Non-Small-Cell Lung/drug therapy*;
Humans;
L-Lactate Dehydrogenase;
Lung Neoplasms/drug therapy*;
Lymphocytes/immunology*;
Neutrophils/immunology*;
Prognosis;
Retrospective Studies
- From:
Chinese Journal of Oncology
2022;44(9):975-980
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To investigate the effects of derived neutrophil to lymphocyte ratio (dNLR) and lung immune prognostic index (LIPI) score on the overall survival (OS) of non-surgical elderly non-small cell lung cancer (NSCLC) patients. Methods: Clinical and pathological data of NSCLC patients in Hebei General Hospital from January 2014 to June 2018 were collected retrospectively. The dNLR value was calculated based on the results of blood routine before treatment, and the optimal cut-off value of dNLR was obtained by ROC curve. The patients were divided into low dNLR level group and high dNLR level group based on the optimal dNLR cut-off value. The groups were classified as good, intermediate and poor based on the LIPI score consisting of lactate dehydrogenase (LDH) and dNLR tested before treatment. The Kaplan-Meier method and Log rank test were used for survival analysis, and the Cox risk proportional regression model was used for analysis of prognostic influences. Results: The area under the ROC curve for dNLR predicting prognosis in non-surgical elderly NSCLC patients was 0.591 (95% CI: 0.491, 0.692; P=0.093). The optimal cut-off value for dNLR predicting prognosis in elderly NSCLC patients was 2.515, with a sensitivity of 45.5% and a specificity of 81.8%. The gender, BMI, pathological type and degree of tumor differentiation were associated with dNLR levels (P<0.05). The median survival times were 16 and 10 months for patients in the low dNLR level group (dNLR<2.51) and high dNLR level group (dNLR≥2.51), respectively (P<0.001), and 15, 10 and 6 months for patients with good, intermediate and poor LIPI scores, respectively (P<0.001). The age, gender, smoking, pathological type, tumor differentiation, clinical stage, BMI, dNLR level, LDH level and LIPI scores were all associated with patient prognosis (P<0.05), and age≥76 years, tumor differentiation and clinical stage Ⅲ and Ⅳ were independent factors influencing patient prognosis (P<0.05). Conclusion: No matter what treatment measures are taken, dNLR level and LIPI score are related to patients' prognosis, and non-surgical elderly NSCLC patients with high dNLR level and poor LIPI score before treatment have worse prognoses.
