Predictive Value Of NLR And LDH In The Efficacy Of Immunotherapy Combine With Chemotherapy For Advanced Gastric Cancer

Objective:To explore the prognostic value of NLR and LDH in patients with advanced gastric cancer receiving immunotherapy combined with chemotherapy.Methods:From January 2019 to June 2022,70 patients with advanced gastric cancer who were treated with immunotherapy combined with chemotherapy in the Affiliated Tumor Hospital of Xinjiang Medical University were selected as the study subjects according to the inclusion and exclusion criteria.The follow-up deadline was December 20,2022.The general clinical data of the patients and the neutrophil to lymphocyte ratio(NLR)and lactate dehydrogenase(LDH)indexes of the patients before the initial combined treatment were collected.The receiver operating characteristic curve(ROC curve)of NLR and LDH was drawn to obtain the cut-off values.The patients were divided into high NLR group,low NLR group,high LDH group and low LDH group.IBM SPSS 26.0 and Graph Pad Prism8 were used for statistical analysis,Kaplan-Meier was used to draw the survival curve,and Cox proportional hazard regression model was used for univariate and multivariate analysis to study the effect of NLR and LDH before treatment on the prognosis of patients with advanced gastric cancer receiving immunotherapy combined with chemotherapy.Results:According to the area under the curve(AUC)of the Roc curve,the cut-off value of NLR was calculated to be 3.39,and the cut-off value of LDH was 210.The PFS(4.5 months vs 12.5 months,P = 0.002)and OS(6.5 months vs 15.1months,P = 0.001)of NLR ≥ 3.39 group were shorter than those of NLR < 3.39 group.The PFS(6.6 months vs 7.3 months,P = 0.716)and OS(5.1 months vs 15.9 months,P =0.007)of LDH ≥ 210 group were shorter than those of LDH < 210 group.Cox univariate and multivariate regression analysis showed that the PFS of gastric cancer patients receiving immunotherapy combined with chemotherapy was related to age and NLR,and age ≥ 60 years and NLR < 3.39 were prognostic risk factors for PFS;the OS of gastric cancer patients receiving immunotherapy combined with chemotherapy was related to ECOG score,NLR and LDH,and ECOG score of 0 was a prognostic risk factor for OS.Conclusion: Baseline NLR is a risk factor for prognosis of immunotherapy combined with chemotherapy in advanced gastric cancer,and elevated pre-treatment NLR and LDH suggest poor prognosis for gastric cancer patients receiving immunotherapy combined with chemotherapy.