Correlation of neutrophil-to-lymphocyte ratio, lymphocyte-to-monocyte ratio, and C-reactive protein with the efficacy and prognosis of immunotherapy in patients with advanced non-small cell lung cancer
10.3760/cma.j.cn341190-20240806-01006
- VernacularTitle:NLR、LMR、CRP与晚期NSCLC患者应用免疫治疗疗效及预后的相关性研究
- Author:
Chenchen WANG
1
;
Tie XIAOWEI
;
Yanshun ZHANG
;
Hongjiang ZHANG
;
Simeng CHEN
;
Yong WANG
;
Chengcheng WANG
;
Haobiao WANG
Author Information
1. 安徽理工大学第一附属医院肿瘤内科，淮南 232001
- Publication Type:Journal Article
- Keywords:
Carcinoma,non-small-cell lung;
Forecasting;
Disease-free survival;
Granulocytes;
Lymphocytes;
Monocytes;
C-reactive protein;
Follow-up studies
- From:
Chinese Journal of Primary Medicine and Pharmacy
2025;32(7):963-967
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the relationship between the neutrophil- to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), C-reactive protein (CRP), and the efficacy of immunotherapy in patients with advanced non-small cell lung cancer (NSCLC).Methods:The clinical data of 47 patients with NSCLC who received immunotherapy at The First Affiliated Hospital of Anhui University of Science and Technology from December 2021 to May 2023 were retrospectively analyzed. Based on the duration of immunotherapy, patients with a duration of more than 1 year were classified as having a good immune response, while those with a duration of less than 1 year were classified as having a poor immune response. The clinical pathological characteristics of patients with good and poor immune responses were compared. The cutoff values for NLR, LMR, and CRP were calculated using receiver operating characteristic curves, and patients were grouped based on these cutoff values. The predictive probabilities of different combinations were compared. Univariate and multivariate Cox analyses were performed to identify factors affecting patient survival.Results:Significant differences were observed in the distribution of therapy lines (1 st-line vs. 2 nd-line treatment), NLR, LMR, and CRP levels between patients with good immune response and those with poor immune responses (all P < 0.05). The area under the curve (AUC) for NLR was 0.763 [95% CI: (0.608, 0.918)], the AUC for LMR was 0.715 [95% CI: (0.544, 0.875)], and the AUC for CRP was 0.697 [95% CI: (0.540, 0.853)]. To assess the diagnostic value of combined indicators in predicting the efficacy of immunotherapy in NSCLC, different indicators were combined, resulting in the variables NLR + LMR, NLR + CRP, LMR + CRP, and NLR + LMR + CRP. Receiver Operating Characteristic curves were plotted based on the probabilities. The combination of NLR + LMR + CRP showed the best predictive performance, with an AUC of 0.897 [95% CI: (0.806, 0.988)]. Univariate and multivariate Cox analyses indicated that LMR [ HR: 0.428; 95% CI: (0.213, 0.858), P = 0.017] and the distribution of treatment lines [ HR: 1.815; 95% CI: (1.005, 3.642), P = 0.033] were important independent prognostic factors for progression-free survival. Conclusions:NLR, LMR, and CRP are correlated with immunotherapy efficacy in patients with NSCLC and provide predictive value. LMR and treatment line are independent prognostic factors for progression-free survival.
