无法手术的晚期非小细胞肺癌患者接受姑息放疗时全身炎症的发生率和预后价值：综合比率与累积评分的比较。

IF 2.9 2区医学 Q2 ONCOLOGY

Cancer Medicine Pub Date : 2024-08-20 DOI:10.1002/cam4.70139

Josh McGovern, Fraser O'Rourke, Sarah Will, Hanh Thi Ngoc Nguyen, Elise Cranfield, Charlotte Maseland, Nicholas MacLeod, John D. Maclay, Barry J. Laird, Ross D. Dolan, Donald C. McMillan

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引用次数: 0

摘要

简介本研究旨在探讨接受姑息性放疗的晚期NSCLC患者（ECOG-PS 0/1）的全身炎症综合比率/累积评分、全身炎症反应（SIR）程度与生存率之间的关系：全身炎症综合比率/累积评分包括中性粒细胞-淋巴细胞比率（NLR）、血小板-淋巴细胞比率（PLR）、淋巴细胞-单核细胞比率（LMR）、C反应蛋白（CRP）-白蛋白（CRP-albumin）、(CRP）-白蛋白比值（CAR）、中性粒细胞-淋巴细胞评分（NLS）、血小板-淋巴细胞评分（PLS）、淋巴细胞-单核细胞评分（LMS）、中性粒细胞-血小板评分（NPS）、改良格拉斯哥预后评分（mGPS）。SIR的大小由血清CRP浓度决定，CRP浓度中值>10毫克/升被视为全身炎症。全身炎症综合比率/累积评分与临床病理特征之间的关系采用卡方分析法进行检验。总生存率（OS）与全身炎症综合比率/累积分数之间的关系采用 Cox 回归分析法进行检验：结果：共纳入 479 例患者。48%（n = 231）的患者为男性，70%（n = 338）的患者年龄≥65 岁。29%（n = 140）的患者 ECOG-PS 为 0，71%（n = 339）的患者 ECOG-PS 为 1。98%（n = 469）的患者在随访期间死亡。中位生存期为 5 个月（2-11 个月）。不同比率/评分的全身炎症发生率相似（NLR >3 68%；LMR 150 70%；CAR >0.20 83%；NLS ≥1 66%；LMS ≥1 71%；NPS≥1 50%；PLS≥1 60%和mGPS≥1 75%）。尽管未被视为全身性炎症，但 NLR 为 10 mg/L。根据 ECOG-PS 调整后，CAR＞0.40（p 结论：CAR＞0.40（p 结论：CAR＞0.40（p 结论：CAR＞0.40（p基于肝脏的全身炎症指标（CAR 和 mGPS）在量化 SIR 的程度方面似乎更为可靠，对晚期 NSCLC 患者具有预后价值。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

The prevalence and prognostic value of systemic inflammation in good performance status patients with advanced, inoperable non-small cell lung cancer receiving palliative radiotherapy: Comparison of composite ratios and cumulative scores

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Introduction

The present study sought to examine the relationships between systemic inflammatory composite ratios/cumulative scores, magnitude of systemic inflammatory response (SIR) and survival in good performance status patients (ECOG-PS 0/1) with advanced NSCLC receiving palliative radiotherapy.

Methods

Systemic inflammatory composite ratios/cumulative scores included the neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), lymphocyte-monocyte ratio (LMR), C-reactive protein, (CRP)-albumin ratio (CAR), neutrophil- lymphocyte score (NLS), platelet-lymphocyte score (PLS), lymphocyte-monocyte score (LMS), neutrophil-platelet score (NPS), modified Glasgow prognostic score (mGPS). The magnitude of SIR was determined by serum CRP concentration, with a median CRP concentration of >10 m mg/L considered to be systemically inflamed. Relationships between systemic inflammatory composite ratios/ cumulative scores and clinicopathological characteristics were examined using chi-square analysis. Relationships between overall survival (OS) and systemic inflammatory composite ratios/ cumulative scores were examined using cox regression analysis.

Results

479 patients were included. 48% (n = 231) of patients were male and 70% (n = 338) were ≥65 years of age. 29% (n = 140) patients were ECOG-PS 0 and 71% (n = 339) were ECOG-PS 1. 98% (n = 469) of patients died during follow-up. The median survival was 5 months (2–11). A similar prevalence of systemic inflammation was noted across the various ratios/scores (NLR >3 68%; LMR <2.4 65%; PLR >150 70%; CAR >0.20 83%; NLS ≥1 66%; LMS ≥1 71%; NPS≥1 50%; PLS≥1 60% and mGPS≥1 75%). Despite not considered to be systemically inflamed, an NLR <3, LMR ≥2.4, PLR ≤150, NLS 0, LMS 0, NPS 0 and PLS 0 all had a median CRP concentration of >10 mg/L. When adjusted for ECOG-PS, CAR>0.40 (p < 0.001) and mGPS 2 (p < 0.05) remained significantly associated with OS.

Conclusion

Liver-based measures of systemic inflammation (CAR and mGPS) appear more reliable for the quantification of the magnitude of SIR and have prognostic value in patients with advanced NSCLC.

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来源期刊

Cancer Medicine ONCOLOGY-

CiteScore

5.50

自引率

2.50%

发文量

907

审稿时长

19 weeks

期刊介绍： Cancer Medicine is a peer-reviewed, open access, interdisciplinary journal providing rapid publication of research from global biomedical researchers across the cancer sciences. The journal will consider submissions from all oncologic specialties, including, but not limited to, the following areas: Clinical Cancer Research Translational research ∙ clinical trials ∙ chemotherapy ∙ radiation therapy ∙ surgical therapy ∙ clinical observations ∙ clinical guidelines ∙ genetic consultation ∙ ethical considerations Cancer Biology: Molecular biology ∙ cellular biology ∙ molecular genetics ∙ genomics ∙ immunology ∙ epigenetics ∙ metabolic studies ∙ proteomics ∙ cytopathology ∙ carcinogenesis ∙ drug discovery and delivery. Cancer Prevention: Behavioral science ∙ psychosocial studies ∙ screening ∙ nutrition ∙ epidemiology and prevention ∙ community outreach. Bioinformatics: Gene expressions profiles ∙ gene regulation networks ∙ genome bioinformatics ∙ pathwayanalysis ∙ prognostic biomarkers. Cancer Medicine publishes original research articles, systematic reviews, meta-analyses, and research methods papers, along with invited editorials and commentaries. Original research papers must report well-conducted research with conclusions supported by the data presented in the paper.