Journal of Practical Oncology ›› 2022, Vol. 36 ›› Issue (6): 544-550.doi: 10.11904/j.issn.1002-3070.2022.06.010

• Clinical Research • Previous Articles     Next Articles

Predictive effect of peripheral blood markers on immune-related adverse reactions of advanced non-small cell lung cancer and their correlation with survival outcome

XU Zihan1, YU Guohua2, NIE Yuhui1, SUN Mengmeng1, FENG Hui1, LIU Shuzhen2   

  1. 1. Clinical Medical College,Weifang Medical University,Weifang 261053,China;
    2. Department of Oncology,Weifang People′s Hospital
  • Received:2022-05-20 Revised:2022-10-11 Online:2022-12-28 Published:2023-01-06

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Abstract: Objective The aim of this study was to investigate the predictive effect of NLR, PLR and LDH on immune-related adverse events(irAEs)in advanced non-small cell lung cancer(NSCLC), and to analyze their correlation between them and survival outcomes.Methods Clinical data of 169 patients with advanced NSCLC who were treated with PD-1/PD-L1 inhibitor in Weifang People′s Hospital from January 1, 2017 to January 1, 2021 were retrospectively analyzed.These patients were divided into the irAEs group(n=61)and non-irAEs group(n=108).The clinical data of the two groups were compared.Receiver operating characteristic(ROC)curve was drawn to determine the threshold value of baseline peripheral blood parameters to predict the occurrence of irAEs.Multivariate logistic regression analysis was used to explore the relationship between peripheral blood markers and the incidence of irAEs.Cox regression model was used to analyze the influencing factors of progression-free survival(PFS)and overall survival(OS).Results The baseline peripheral blood NLR and PLR of patients in the irAEs group were lower than those in the non-irAEs group, and the LDH was higher than those in the non-irAEs group(P＜0.05).The best critical values of NLR, PLR and LDH before treatment for predicting the occurrence of irAEs were 3.18(AUC=0.80), 181.56(AUC=0.62), and 209.50(AUC=0.63), respectively.Multivariate logistic regression analysis showed that low NLR and high LDH were independent risk factors for the occurrence of irAEs(P＜0.05).The PFS and OS in low NLR, low PLR and low LDH groups were significantly better than those in the high NLR, high PLR and high LDH groups(P＜0.05).Cox regression model showed that high NLR, high PLR and high LDH were independent risk factors for PFS and OS.Conclusion NLR and LDH can predict the occurrence of irAEs in advanced NSCLC patients.High NLR, high PLR, and high LDH are associated with poor prognosis of immunotherapy for advanced NSCLC.

Key words: Non-small cell lung cancer, Peripheral blood markers, Immune-related adverse reactions, Prediction, Prognosis

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