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中国当代医药  2022, Vol. 29 Issue (20): 20-25    
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中性粒细胞/淋巴细胞比值对晚期肺癌免疫检查点抑制剂相关性肺炎的预测价值
韩利会      田辉      杨秋安▲
山东大学齐鲁医院肿瘤放疗科,山东济南   250012
Predictive value of neutrophil to lymphocyte ratio in immune checkpoint inhibitor-related pneumonitis in lung cancer
HAN Lihui   TIAN Hui   YANG Qiu′an▲
Department of Radiation Oncology, Qilu Hospital of Shandong University, Shandong Province, Ji′nan   250012, China
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摘要 目的 探讨外周血淋巴细胞亚群及炎症相关指标在晚期肺癌免疫检查点抑制剂相关性肺炎(CIP)发生中的预测价值。方法 回顾性分析2019年2月至2021年11月山东大学齐鲁医院行PD-1/PD-L1抑制剂治疗且行淋巴细胞亚群检测的77例晚期肺癌患者的临床资料。根据是否发生CIP,将其分为CIP组(11例)和非CIP组(66例)。比较两组患者的淋巴细胞亚群水平、中性粒细胞/淋巴细胞比值(NLR)、淋巴细胞/单核细胞比值(LMR)和血小板/淋巴细胞比值(PLR)的差异,并采用ROC曲线评估各指标对CIP发生的预测价值。结果 随访期间,11例患者发生了CIP,发生率14.3%。CIP组患者的基线NLR高于非CIP组,差异有统计学意义(P<0.05);但两组患者的淋巴细胞亚群水平、LMR和PLR比较,差异无统计学意义(P>0.05)。ROC曲线显示,NLR对CIP预测的AUC为0.718(95%CI:0.502~0.933),截断值为4.50,敏感度为75.8%,特异度为72.7%。结论 晚期肺癌患者免疫治疗前NLR可作为CIP预测指标,但淋巴细胞亚群、LMR和PLR与CIP的发生无明显相关。
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韩利会
田辉
杨秋安
关键词 肺癌中性粒细胞/淋巴细胞比值淋巴细胞亚群PD-1/PD-L1抑制剂免疫检查点抑制剂相关性肺炎    
Abstract:Objective To investigate the predictive value of peripheral blood lymphocyte subsets and inflammation related indexes in the occurrence of immune checkpoint inhibitor associated pneumonia (CIP) in advanced lung cancer. Methods A retrospective analysis was performed on the clinical data of 77 patients with advanced lung cancer who received PD-1/PD-L1 inhibitor treatment and lymphocyte subsets detection in Qilu Hospital of Shandong University from February 2019 to November 2021. According to the occurrence of CIP, they were divided into CIP group (11 cases) and non-CIP group (66 cases). The levels of lymphocyte subsets, neutrophil to lymphocyte ratio (NLR), lymphocyte to monocyte ratio (LMR) and platelet/lymphocyte ratio (PLR) were compared between two groups, and the predictive value of each indicator for CIP occurrence was evaluated by ROC curve. Results During follow-up, CIP occurred in 11 patients, the incidence of 14.3%. The baseline NLR in CIP group was higher than that in non-CIP group, and the difference was statistically significant (P<0.05). However, there were no significant differences in lymphocyte subsets, LMR and PLR between two groups (P>0.05). ROC curve showed that the AUC predicted by NLR for CIP was 0.718 (95%CI: 0.502-0.933), the cut-off value was 4.50, the sensitivity was 75.8%, and the specificity was 72.7%. Conclusion NLR can be used as a predictor of CIP in advanced lung cancer patients before immunotherapy, but lymphocyte subsets, LMR and PLR have no significant correlation with CIP occurrence.
Key wordsLung cancer    Neutrophil to lymphocyte ratio    Lymphocyte subsets    Anti-PD-1/PD-L1 immunotherapy; Checkpoint inhibitor-related pneumonitis
    
通讯作者: 杨秋安(1964-),男,山东济宁人,博士,副主任医师,硕士生导师,山东大学齐鲁医院东院区肿瘤放疗科主任,研究方向:头颈部肿瘤和肺癌的放射治疗及生物靶向治疗。   
作者简介: 韩利会(1990-),女,山东菏泽人,山东大学2021级放射肿瘤学专业在职博士研究生,研究方向:肺癌的放射治疗和免疫治疗。
引用本文:   
韩利会; 田辉; 杨秋安. 中性粒细胞/淋巴细胞比值对晚期肺癌免疫检查点抑制剂相关性肺炎的预测价值[J]. 中国当代医药, 2022, 29(20): 20-25.
HAN Lihui ; TIAN Hui ; YANG Qiu′an. Predictive value of neutrophil to lymphocyte ratio in immune checkpoint inhibitor-related pneumonitis in lung cancer. 中国当代医药, 2022, 29(20): 20-25.
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