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.

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.

Objective:To analyze the relationship between plasma D-dimer level and cancer-related fatigue and quality of life in patients with lung cancer after chemotherapy.Methods:A cross-sectional study was conducted involving 58 patients with stage ⅠB-ⅢA lung cancer who received chemotherapy at The First Hospital of Anhui University of Science and Technology from January 2020 to December 2023. These patients comprised the observation group. The control group consisted of 41 patients diagnosed with lung cancer who had completed adjuvant chemotherapy and entered the follow-up stage. The plasma D-dimer level in the observation group was monitored before and after four cycles of postoperative adjuvant chemotherapy. The plasma D-dimer level in the control group was monitored before and after 3 months of follow-up. The Chinese version of the Cancer Fatigue Scale and the Chinese version of the Functional Assessment of Cancer Therapy-Lung (FACT-L) were used to evaluate cancer-related fatigue levels and quality of life in both groups. Pearson correlation analysis was performed to assess the relationship between plasma D-dimer levels and cancer-related fatigue and quality of life.Results:After four cycles of chemotherapy and 3 months of follow-up, the plasma D-dimer level in the observation group was significantly higher than that in the control group [(1.17 ± 0.32) mg/L vs. (0.66 ± 0.29) mg/L, t = -8.26, P < 0.001]. The score of the Chinese version of the FACT-L in the observation group was significantly higher than that in the control group [(79.82 ± 9.74) points vs. (67.49 ± 8.12) points, t = -6.85, P < 0.001]. The scores for tumor-related symptoms, physiological status, social/family status, functional status, and emotional status in the FACT-L for the observation group were (21.26 ± 3.17) points, (14.37 ± 2.24) points, (22.63 ± 3.48) points, (11.53 ± 2.13) points, and (14.79 ± 2.73) points, which were significantly lower than those in the control group [(22.42 ± 3.31) points, (17.65 ± 2.64) points, (25.12 ± 3.39) points, (16.34 ± 2.68) points, (16.37 ± 2.76) points, t = 3.26, 6.48, 3.56, 3.60, 2.82, all P < 0.05]. Pearson correlation analysis revealed that the plasma D-dimer level was positively correlated with the cancer-related fatigue score ( r = 0.367, P < 0.001) and negatively correlated with the total FACT-L score ( r = -0.334, P < 0.001). Conclusion:In patients with stage ⅠB-ⅢA lung cancer after surgery, changes in plasma D-dimer levels during adjuvant chemotherapy are associated with the degree of cancer-related fatigue and affect quality of life. Therefore, monitoring plasma D-dimer levels can provide important reference value for assessing the outcome of chemotherapy and guiding clinical treatment.