Study On The Correlation Between Inflammation And Nutrition Related Indexes And Prognosis Of Patients With Advanced Lung Cancer

Objective: The purpose of this study was to investigate the correlation between Neutrophil to lymphocyte ratio（NLR）,platelet to lymphocyte ratio,PLR,Systemic immune immune inflammation index（SII）,lymphocyte to Monocyte ratio,LMR,hemoglobin-to-red blood cell distribution width ratio（HRR）,hemoglobin-to-red blood cell distribution width ratio（HRR）,prognostic nutrition index Hemoglobin（PNI）,Hemoglobin（HB）,albumin,lymphocyte,and platelet score（HALP）and other indicators in patients with advanced lung cancer before treatment and prognosis.Methods: A retrospective analysis was performed on 274 lung cancer patients who received chemotherapy for the first time and did not receive surgery from The First Hospital of Lanzhou University from August 1,2018 to December 31,2020.Basic information,pathological type,treatment plan,complete blood count before treatment and biochemical parameters of patients were collected by electronic medical record system.NLR,PLR,SII,LMR,HRR,PNI and HALP of peripheral blood were obtained by calculation.The cutoff values of NLR,PLR,SII,LMR,HRR,PNI and HALP are determined by X-tile software,and the optimal critical value is obtained and then grouped.Kaplan-meier method was used to perform single-factor survival analysis of OS,and log-rank test was performed.Multivariate survival analysis of OS was performed by COX proportional risk regression.P < 0.05 was considered statistically significant.Results: 1.The cutoff values of NLR,PLR,SII,LMR,HRR,PNI and HALP are determined by X-tile software,and the best cutoff values are 3.64,217.72,1088.44,2.07,2.86,47.10 and 31.16,respectively.2.Patients were grouped according to the optimal truncation values of NLR,PLR,SII,LMR,HRR,PNI and HALP.NLR was associated with BMI and diabetes history of lung cancer patients with P values of 0.010 and 0.016,respectively,but not with other clinicopathological features（P ≥ 0.05）.PLR was not associated with the clinicopathological characteristics of lung cancer patients,such as the history of hypertension and diabetes（P ≥ 0.05）.SII was associated with the history of diabetes in lung cancer patients（P = 0.010）,but not with other clinicopathological features（P ≥ 0.05）.LMR was not associated with the clinicopathological characteristics of lung cancer patients,such as the history of hypertension and diabetes（P ≥ 0.05）.HRR was associated with hypertension in lung cancer patients（P = 0.030）,but not with other clinicopathological features（P ≥ 0.05）.PNI was associated with diabetes history of lung cancer patients（P = 0.046）,but not with other clinicopathological features（P ≥ 0.05）.HALP was associated with BMI of lung cancer patients（P = 0.010）,and was not associated with other clinicopathological features（P ≥ 0.05）.3.Kaplan-meier univariate survival analysis showed that low NLR,low PLR,low SII,high LMR,high PNI,high HALP,high BMI,stage III,ECOG 0-1 were significantly correlated with longer OS,and the P values were as follows: < 0.001,0.004,< 0.001,< 0.001,0.029,0.007,0.024,0.002,< 0.001.HRR,age,history of hypertension,gender,smoking history,diabetes history and pathological type had no significant correlation with OS,and all P values were ≥0.05.Median OS of low NLR vs high NLR,low PLR vs high PLR,low SII vs high SII,high LMR vs low LMR,high PNI vs low PNI,high HALP vs Low HALP,high BMI vs low BMI,Stage III vs IV,ECOG 0-1 group and ECOG > 1 group were 18.10 months vs 11.87 months（HR=0.36,95%CI: 0.26-0.50,P < 0.001）and 16.83 months vs 12.57 months（HR=0.56,95%CI: 0.37-0.83,P=0.004）,17.30 months vs 12.57 months（HR=0.43,95%CI: 0.28-0.64,P < 0.001）,17.30 months vs 11.07 months（HR=0.28,95%CI: 0.17-0.45,P < 0.001）,17.20 months vs 14.53 months（HR=0.73,95%CI:0.55-0.97,P=0.029）,17.30 months vs 13.30 months（HR=0.66,95%CI: 0.49 to 0.90,P=0.007）,22.47 months vs 15.23 months（HR=0.68,95%CI: 0.48 to 0.95,P=0.024）,18.10 months vs 15.00 months（HR=0.64,95%CI: 0.48 to 0.85,P=0.002）,17.40 months vs.13.10 months（HR=0.28,95%CI: 0.14 to 0.55,P < 0.001）.4.COX multivariate survival analysis showed that NLR,LMR,TNM stage and ECOG score were independent prognostic factors for lung cancer patients.Low NLR（P=0.002）,high LMR（P=0.002）,stage III（P=0.013）and ECOG 0-1（P < 0.001）were associated with longer OS.Conclusions: NLR and LMR are independent prognostic factors for OS in lung cancer patients.Low NLR and high LMR are significantly correlated with longer OS.PLR,SII,PNI and HALP were not independent prognostic factors for OS in lung cancer patients,but low PLR,low SII,high PNI and high HALP were significantly correlated with longer OS.HRR was not associated with prognosis in patients with lung cancer.