治疗前NLR对于接受卡瑞利珠单抗联合靶向治疗的肝癌患者的预后预测价值

The Predictive Value of NLR before Treatment for the Prognosis of Liver Cancer Patients Receiving Carolizumab Therapy Combined with Targeted Therapy

摘要: 目的：探讨治疗前中性粒细胞与淋巴细胞比值(Neutrophil-to-Lymphocyte Ratio, NLR)对接受卡瑞利珠单抗联合靶向治疗的中晚期肝细胞癌(Hepatocellular Carcinoma, HCC)患者的预后预测价值。方法：绘制受试者工作特征曲线(Receiver Operating Characteristic Curve, ROC)以确定最佳截止值，根据最佳截断值将患者分为NLR低值组和NLR高值组。分析比较两组患者的临床资料、总生存期(Overall Survival, OS)、无进展生存期(Progression Free Survival, PFS)差异。结果：NLR低值组和NLR高值组的中位OS分别为10.5个月和9.6个月(P < 0.05)。NLR低值组和NLR高值组的中位PFS分别为6.5个月和5.0个月(P < 0.05)。NLR低值组的ORR显著优于NLR高值组(37.1% vs 14.3%, P = 0.029)，NLR低值组的DCR也显著优于NLR高值组(60.0% vs. 28.6%, P = 0.008)。单变量和多变量Cox比例风险模型分析显示，治疗前NLR > 2.11是影响患者OS和PFS的独立危险因素。结论：治疗前NLR对接受卡瑞利珠单抗联合靶向治疗的肝癌患者具有良好的预测价值。

Abstract: Purpose: To investigate the prognostic value of the pre-treatment neutrophil-to-lymphocyte ratio (NLR) in patients with intermediate-advanced hepatocellular carcinoma (HCC) treated with targeted therapy combined with immunotherapy. Methods: Draw the receiver operating characteristic curve (ROC) to determine the optimal cutoff value. According to the optimal cutoff value, the patients were divided into the NLR-low group and the NLR-high group. Analyze and compare the clinical data, overall survival (OS), and progression free survival (PFS) differences between the two groups of patients. Results: The median OS of the NLR-low group and the NLR-high group were 10.5 months and 9.6 months (P < 0.05), respectively. The median PFS of the NLR-low group and the NLR-high group were 6.5 months and 5.0 months (P < 0.05), respectively. The ORR of the NLR-low group was significantly better than that of the NLR-high group (37.1% vs 14.3%, P = 0.029), and the DCR of the NLR-low group was also significantly better than that of the NLR-high group (60.0% vs. 28.6%, P = 0.008). Univariable and multivariable Cox proportional hazard model analyses showed that NLR > 2.11 before treatment was an independent risk factor affecting patients OS and PFS. Conclusion: Pre-treatment NLR has a good predictive value for patients with advanced HCC who received Camrelizumab combined with targeted therapy.