The Predictive Value Of Lung Immune Prognostic Index On The Curative Effect Of Sintilimab Combined With Chemotherapy In The Treatment Of Advanced Non-small Cell Lung Cancer

Objective:To study the predictive value of the lung immune prognostic index(LIPI)score on the curative effect of sintilimab combined with chemotherapy in the treatment of advanced non-small cell lung cancer,analyze the factors affecting the curative effect of non-small cell lung cancer patients,and find effective predictive indicators.Methods:The medical records of 64 patients with unresectable stage III and IV non-small cell lung cancer with negative driver gene in Fenyang Hospital of Shanxi Province from January 2020 to June 2022 were collected.The derived neutrophil / lymphocyte ratio(d NLR)and lactate dehydrogenase(LDH)were calculated according to the results of blood routine before treatment.According to the score of pulmonary immune prognostic index,the patients with NSCLC were divided into three groups: good group(d NLR < 3 and LDH< 250U/L),moderate group(d NLR > 3 or LDH > 250U/L)and poor group(d NLR > 3 and LDH > 250U/L).The general clinical data of patients with non-small cell lung cancer including blood routine,LDH,age,sex,smoking history,pathological type,body mass index,tumor stage and PS score were collected to analyze the factors affecting the disease progression of patients with non-small cell lung cancer.SPSS26.0 statistical software was used to analyze and process the patient data.The measurement data in accordance with normal distribution were expressed by mean ± standard deviation,the comparison between groups was expressed by analysis of variance,the rate of counting data(percentage)was expressed,and the comparison between groups was expressed by 2-test or Fisher accurate test.Cox proportional hazard regression model was used in univariate and multivariate analysis.Single-factor meaningful variables were included in the multivariate regression model,and the risk values of covariables(HR)and 95% confidence interval of HR were calculated.Survival analysis was performed by Kaplan-Meier method and log-rank test.The difference was statistically significant(P < 0.05).Results:Among the 64 patients with unresectable non-small cell lung cancer with negative driver genes,the effects of age,sex,smoking history,pathological type,body mass index,tumor stage,PS score,LDH,d NLR,and LIPI score on non-small cell lung cancer were analyzed.In terms of the impact on PFS of lung cancer,the median PFS of the poor LIPI score group was 6.5 months,which was shorter than that of the good group(9.5 months)and the moderate group(9 months).Cox univariate regression analysis showed that poor LIPI score group,LDH>250U/L and d NLR>3 were associated with shorter PFS.However,age,gender,smoking history,pathological type,body mass index,tumor stage,and PS score had no significant effect on PFS in non-small cell lung cancer.Cox multivariate regression analysis showed that,compared with the moderate group and the good group,the poor LIPI score group may be an independent risk factor for the prognosis of patients with advanced non-small cell lung cancer treated with Sintilimab combined with chemotherapy.Conclusion:LIPI score has some correlation with the prognosis of advanced NSCLC.Patients with poor score have poor prognosis.LIPI score can be used as a prognostic indicator for patients with advanced NSCLC treated with Sintilimab combined with chemotherapy.