SII/ALB与EGFR基因突变型晚期非小细胞肺癌预后的相关性分析

Correlation between SII/ALB and the Prognosis of EGFR Gene Mutation in Advanced Non-Small Cell Lung Cancer

摘要: 探讨全身免疫–炎症指数/血清白蛋白(SII/ALB)与EGFR基因突变型晚期非小细胞肺癌预后的相关性分析。收集从2013年6月12日至2017年6月31日在青岛市市立医院诊断的EGFR突变型晚期非小细胞肺癌患者71例，患者服用EGFR-TKI前2周内抽取静脉血，收集临床数据。计算患者的SII/ALB值，以中位数将患者分高、低SII/ALB组。两组患者的PFS曲线应用Kaplan-Meier法比较，之后用Log-rank检验分析两组患者PFS的差异。PFS的影响因素通过Cox单因素、多因素回归进行分析，P < 0.05为差异有统计学意义。高SII/ALB组患者的中位无进展生存期(mPFS)为9.2个月，低SII/ALB组患者的mPFS为14.5个月，Kaplan-Meier法显示低SII/ALB组患者的PFS明显优于高SII/ALB组的患者(Log-rank P < 0.001)。3、Cox单因素回归方法分析提示患者的性别、肿瘤分期、EGFR-TKI初治前血清白蛋白和外周血中性粒细胞、淋巴细胞、血小板计数及SII/ALB值对EGFR-TKI治疗的EGFR突变型晚期非小细胞肺癌患者的PFS的影响有意义，均P < 0.05。应用Cox多因素回归方法分析显示肿瘤分期(HR = 4.124, 95% CI: 1.593~10.675; P = 0.004)、外周血淋巴细胞计数(HR = 0.565, 95% CI: 0.290~0.744; P = 0.000)、SII/ALB (HR = 2.472，95% CI: 1.055~5.788; P = 0.037)是应用EGFR-TKI治疗的EGFR突变型晚期非小细胞肺癌患者PFS的独立影响因素。结论：SII/ALB可作为预测EGFR-TKI治疗EGFR敏感突变型晚期非小细胞肺癌患者预后的指标。

Abstract: To investigate the correlation between systemic immune-inflammation index/albumin (SII/ALB) and the prognosis of patients with advanced non-small cell lung cancer (NSCLC) with epithelial growth factor receptor (EGFR) gene sensitive mutation. From June 12, 2013 to June 31, 2017, the demographic and clinicopathological characterictics of 71 NSCLC patients with EGFR sensitive mutation in Qingdao Municipal Hospital of Shandong Province were collected. Venous blood was collected from the patients within 2 weeks before the treatment of EGFR tyrosine kinase inhibitor (EGFR-TKI). The data of SII/ALB of the patients were calculated, and the patients were divided into high and low SII/ALB groups by median. The progression-free survival (PFS) curves of the two groups were compared by Kaplan-Meier method, and the differences in PFS between the two groups were analyzed by log-rank test. The influencing factors of PFS were analyzed by univariate and multivariate Cox regression analysis, and P < 0.05 was considered statistically significant. In the high SII/ALB group, the median PFS was 9.2 months, and mPFS of patients in the low SII/ALB group was 14.5 months. Kaplan-Meier method showed that patients in the low SII/ALB group had significantly better PFS than those in the high SII/ALB group (log-rank P < 0.001). Univariate Cox analysis suggested that gender, tumor stage, serum albumin, peripheral blood neutrophil count, lymphocyte count, platelet count and SII/ALB had significant effects on PFS in patients, P<0.05. Multivariate Cox regression analysis showed tumor staging (HR = 4.124, 95% CI: 1.593 - 10.675; P = 0.004), peripheral blood lymphocyte count (HR = 0.565, 95% CI: 0.290 - 0.744; P = 0.000) and SII/ALB (HR = 2.472, 95% CI: 1.055 - 5.788; P = 0.037) were independent factors affecting PFS in advanced NSCLC patients with EGFR-sensitive mutant treated with EGFR-TKI. Conclusions: SII/ALB can be used to predict the prognosis of EGFR-TKI in the treatment of EGFR mutant advanced non-small cell lung cancer.