炎症免疫综合指数在免疫检查点抑制剂治疗肺癌患者中的预测价值及模型构建OA

Objective To investigate the prognostic value of comprehensive inflammatory immune composite index(IICS)based on peripheral blood inflammatory markers in non-small cell lung cancer(NSCLC)patients treated with immune checkpoint inhibitors.Methods The clinical data of 157 NSCLC patients who received immunotherapy in the First Affiliated Hospital of Shihezi University from January 2021 to January 2023 were retrospectively collected.The cut-off values of in-flammatory markers were determined by ROC curve and IICS were constructed.Kaplan-Meier method and Cox regression were used to analyze the prognostic significance,and R language was used to construct the prediction model.The calibration curve was used to internally verify the prediction model.Results By the end of follow-up,8 of 157 patients were lost to follow-up,and the follow-up rate was 91.08%.A total of 149 patients who completed follow-up(including those with death endpoint recorded)were divided into sur-vival group(84 cases)and death group(65 cases)according to the prognosis.There were significant differences in the baseline Eastern Cooperative Oncology Group performance status(ECOG PS)scores,distant metastasis,pan-immune inflammation value(PIV),platelet-to-lymphocyte ratio(PLR),systemic immune inflammation index(SII),systemic inflam-mation response index(SIRI),platelet-to-albumin ratio(PAR),prognostic nutritional index(PNI),lymphocyte-to-monocyte ratio(LMR),and advanced lung cancer inflammation index(ALI)between the two groups(P＜0.05).The constructed IICS based on the inflammatory indexes had prognostic value for NSCLC patients receiving immunotherapy.The AUC was 0.71(95%CI:0.62-0.79,P＜0.001),and the best cut-off value was＞3.Survival analysis showed that patients with low baseline IICS had longer progression free survival(PFS)than those with high IICS(P＜0.001).Multivariate Cox regression analysis showed that age,smoking history,ECOG PS score,distant metastasis,and IICS were independent prognostic factors(P＜0.05).The AUC of the prediction model for 1-year PFS rate was 0.84(95%CI:0.73-0.87),and the calibration curve showed that the model fitted well.Conclusion The prediction model based on IICS is of great value for the prognosis evaluation of NSCLC patients treated with immunotherapy,which is helpful for clinical individualized decision-making.