目标:肺癌,癌症相关死亡的最常见原因,大部分被诊断为晚期,5年生存率约为5.8%。确定可靠的预后因素以优化治疗反应至关重要。指导治疗策略,为新研究铺平道路。在这项研究中,我们旨在探讨晚期非小细胞肺癌(NSCLC)的最强预后因素.
方法:我们回顾性分析了278例NSCLC患者。我们使用Kaplan-Meier分析和Cox回归分析评估了潜在预后因素与总生存期(OS)时间之间的相关性。
结果:所有患者的中位OS为15.3个月。在单变量分析中,性别,组织学类型,性能状态,免疫疗法,放射治疗,血红蛋白水平,血清白蛋白,钠球蛋白比(SGR),中性粒细胞-淋巴细胞比率(NLR),全身免疫炎症指数(SII),血红蛋白-白蛋白-淋巴细胞-血小板评分(HALP),晚期肺癌指数(ALI)与生存率相关。建立多变量分析模型。在模型中,NLR,SGR,HALP,免疫疗法,放射治疗,和东部肿瘤协作组(ECOG)的表现状态显示出独立的预后特征(分别为p<0.001,p=0.003,p=0.002,p<0.001,p=0.010和p=0.025).此外,在亚组分析中,预后指标(NLR,SGR,发现和HALP)对多个亚组的生存有预后影响。
结论:预处理NLR,SGR,HALP,免疫疗法,放射治疗,和ECOG表现状态是晚期NSCLC患者的独立预后因素。这些预后因素可以在临床实践中使用,简单,和临床医生有用的工具。
OBJECTIVE: Lung cancer, the most common cause of cancer-related death, is diagnosed mostly in advanced stages, and 5-year survival is approximately 5.8%. It is critical to identify reliable prognostic factors to optimize treatment responses, guide therapeutic strategies and pave the way to new research. In this study, we aimed to investigate the strongest prognostic factors for advanced non-small cell lung cancer (NSCLC).
METHODS: We retrospectively analyzed 278 patients with NSCLC. We evaluated the association between potential prognostic factors and overall survival (OS) times using Kaplan-Meier analysis and Cox regression analysis.
RESULTS: The median OS in all patients was 15.3 months. In univariate analysis, gender, histologic type, performance status, immunotherapy, radiotherapy, hemoglobin level, serum albumin, sodium-globulin ratio (SGR), neutrophil-lymphocyte ratio (NLR), systemic immune inflammation index (SII), hemoglobin-albumin-lymphocyte-platelet score (HALP), and advanced lung cancer index (ALI) were associated with survival. Models were established for multivariate analyses. In the models, NLR, SGR, HALP, immunotherapy, radiotherapy, and Eastern Cooperative Oncology Group (ECOG) performance status showed independent prognostic features (p < 0.001, p = 0.003, p = 0.002, p < 0.001, p = 0.010, and p = 0.025, respectively). In addition, in the subgroup analysis, prognostic indexes (NLR, SGR, and HALP) were found to have a prognostic effect on survival in multiple subgroups.
CONCLUSIONS: Pretreatment NLR, SGR, HALP, immunotherapy, radiotherapy, and ECOG performance status are independent prognostic factors for advanced NSCLC patients. These prognostic factors can be used in clinical practice as easily accessible, simple, and useful tools for clinicians.