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已发表论文
中性粒细胞/淋巴细胞比值、血小板/淋巴细胞比值、淋巴细胞/单核细胞比值、中性粒细胞与血小板绝对数比值及D-二聚体对广泛期小细胞肺癌一线免疫治疗疗效与预后的预测价值
Authors Shen Y, Wang J, Hua Q, Dong M
Received 3 August 2025
Accepted for publication 19 November 2025
Published 10 December 2025 Volume 2025:18 Pages 17211—17222
DOI https://doi.org/10.2147/JIR.S557312
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Dr Junhao Wang
Yuanyuan Shen,1,* Jinnan Wang,2,* Qingling Hua,1 Menghao Dong3
1Department of Medical Oncology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, People’s Republic of China; 2Department of Oncology, Anhui Chest Hospital, Hefei, Anhui, People’s Republic of China; 3Department of Clinical Oncology, The First Affiliated Hospital of University of Science and Technology of China (USTC), Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Qingling Hua, Department of Medical Oncology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, People’s Republic of China, Email drhuaql@outlook.com Menghao Dong, Department of Clinical Oncology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, No. 17 Lujiang Road, Luyang District, Hefei, Anhui, People’s Republic of China, Email docdongmenghao@126.com
Purpose: To investigate the predictive value of peripheral blood neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), neutrophil percentage-to-albumin-ratio (NPAR), and D-dimer in the efficacy and prognosis of immunotherapy for extensive-stage small cell lung cancer (ES-SCLC).
Patients and Methods: A total of 70 ES-SCLC were included. The diagnostic performance of inflammatory indexes and D-dimer in predicting the efficacy and prognosis of immunotherapy was evaluated using receiver operating characteristic curve (ROC). Disease control rate (DCR) was used as the assessment indicator for immunotherapy efficacy, and progression free survival (PFS) > 6 months was used as the judgement indicator for better prognosis. Using Lasso regression and logistic multivariate analysis to predict the efficacy and prognosis of immunotherapy, and the optimal cut-off value was determined according to the area under the ROC curve. Kaplan-Meier survival analysis was applied to compare survival differences between groups.
Results: At baseline, PLR can predict the efficacy of immunotherapy in ES-SCLC patients, but cannot predict their prognosis. After two cycles of immunotherapy, NLR can not only predict the efficacy and prognosis of immunotherapy, but also be identified as an independent predictor of long-term PFS in multivariate analysis (P< 0.01). The long-term PFS rate of the low NLR2 group (< 2.2) was significantly higher than that of the high NLR2 group (≥ 2.2) (P< 0.001), with median PFS of 4.83 months vs 9.9 months, respectively, P< 0.001.
Conclusion: After two cycles of chemotherapy combined with immunotherapy, the efficacy and prognosis of NLR and ES-SCLC immunotherapy are closely related and can serve as effective and reliable predictive indicators.
Keywords: inflammatory indicators, D-dimer, immunotherapy, therapeutic effect prediction
1Department of Medical Oncology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, People’s Republic of China; 2Department of Oncology, Anhui Chest Hospital, Hefei, Anhui, People’s Republic of China; 3Department of Clinical Oncology, The First Affiliated Hospital of University of Science and Technology of China (USTC), Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Qingling Hua, Department of Medical Oncology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, People’s Republic of China, Email drhuaql@outlook.com Menghao Dong, Department of Clinical Oncology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, No. 17 Lujiang Road, Luyang District, Hefei, Anhui, People’s Republic of China, Email docdongmenghao@126.com
Purpose: To investigate the predictive value of peripheral blood neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), neutrophil percentage-to-albumin-ratio (NPAR), and D-dimer in the efficacy and prognosis of immunotherapy for extensive-stage small cell lung cancer (ES-SCLC).
Patients and Methods: A total of 70 ES-SCLC were included. The diagnostic performance of inflammatory indexes and D-dimer in predicting the efficacy and prognosis of immunotherapy was evaluated using receiver operating characteristic curve (ROC). Disease control rate (DCR) was used as the assessment indicator for immunotherapy efficacy, and progression free survival (PFS) > 6 months was used as the judgement indicator for better prognosis. Using Lasso regression and logistic multivariate analysis to predict the efficacy and prognosis of immunotherapy, and the optimal cut-off value was determined according to the area under the ROC curve. Kaplan-Meier survival analysis was applied to compare survival differences between groups.
Results: At baseline, PLR can predict the efficacy of immunotherapy in ES-SCLC patients, but cannot predict their prognosis. After two cycles of immunotherapy, NLR can not only predict the efficacy and prognosis of immunotherapy, but also be identified as an independent predictor of long-term PFS in multivariate analysis (P< 0.01). The long-term PFS rate of the low NLR2 group (< 2.2) was significantly higher than that of the high NLR2 group (≥ 2.2) (P< 0.001), with median PFS of 4.83 months vs 9.9 months, respectively, P< 0.001.
Conclusion: After two cycles of chemotherapy combined with immunotherapy, the efficacy and prognosis of NLR and ES-SCLC immunotherapy are closely related and can serve as effective and reliable predictive indicators.
Keywords: inflammatory indicators, D-dimer, immunotherapy, therapeutic effect prediction