Study On The Relationship Between SII,proGRP,GPS,mGPS And The Efficacy Of Chemotherapy In Small Cell Lung Cancer

Objective:Explore system immune inflammatory index(SII),gastrin releasing peptide precursor(proGRP),Glasgow prognostic score(GPS),and modified Glasgow prognostic score(mGPS)and the general clinical characteristics of small cell lung cancer,chemotherapy efficacy,and progression-free survival(PFS),to find out which may be an indicator to predict the chemotherapy efficacy and PFS of small cell lung cancer.Methods:We selected 102 patients with small cell lung cancer who were diagnosed and treated for the first time in the First Affiliated Hospital of Bengbu Medical College from November 2013 to November 2018.All of them were diagnosed by pathology and/or cytology.Collect peripheral blood inflammatory factors(neutrophil count,lymphocyte count,platelet count),peripheral blood proGRP and serum albumin data 1 week before the first chemotherapy.Through receiver operating characteristic curve(Receiver operating characteristic curve,ROC curve)analysis to determine the best cut-off value of SII and proGRP.All patients were grouped according to the cutoff value and GPS and mGPS scoring standards.The intravenous chemotherapy regimen for all patients was EP(etoposide + cisplatin)regimen.The curative effect was evaluated after chest CT examination before the first and third chemotherapy,and SII,proGRP,GPS,mGPS and general clinical characteristics were analyzed.The relationship between chemotherapy efficacy and PFS,and COX regression analysis was used to further analyze the factors affecting PFS in patients with small cell lung cancer.Results:According to the ROC curve,the best cut-off value of proGRP is 2977.40pg/L,and the best cut-off value of SII is 1173.97.Among them,30 patients were in the high proGRP group(proGRPS>2977.40pg/L),72 patients were in the low proGRP group(proGRPS≤2977.40pg/L),and the objective response rate(ORR)of patients in the low proGRP group was higher than that in the high proGRP group.(83.30% vs 60.00%)(χ2=6.048,P=0.011).The chi-square test showed that the peripheral blood proGRP level before the first chemotherapy was significantly related to the clinical stage(P<0.01).A univariate analysis of PFS found that clinical staging and proGRP levels were related to PFS.Gender,age,smoking history,PS score,GPS,mGPS,and SII levels were not related to PFS.The median PFS of patients in the low proGRP group was higher than that in the high proGRP group.PFS was long(8.1 months: 6.7 months,P<0.05);PFS multivariate analysis found that proGRP level is an independent prognostic factor affecting PFS in patients with small cell lung cancer.Conclusion:1.Peripheral blood proGRP levels before initial chemotherapy are significantly related to clinical stages;2.Peripheral blood high proGRP group patients before initial chemotherapy lower proGRP group patients have a better objective response rate,which can be used as a predictor of clinical efficacy in patients with small cell lung cancer Item indicators;3.Among the small cell lung cancer patients who are only using EP regimen regular chemotherapy,the level of peripheral blood proGRP before the initial chemotherapy may be an independent prognostic factor of PFS in small cell lung cancer patients.