The Value Of Platelet-related Parameters Combined With Other Tumor Markersin The Diagnosis And The Prognosis Of Targeted Therapy In Lung Cancer

Research background: Lung cancer is the tumor with highest incidence and mortality in the world.Early diagnosis and timely treatment can improve the treatment effect and overall survival time of patients.Platelet and its related parameters play an important role in the occurrence and development of cancer.Platelets play an important role in promoting the development of tumors,and lymphocytes are the main anti-tumor cells.Therefore,an increase in platelet and lymphocyte ratio(PLR)means an increase in tumor-promoting effects or a resistance to tumors.,which can affect the therapeutic effect and the prognosis of cancer patients.Some parameters play an important role in the diagnosis of cancer,and some affect the treatment effect and prognosis of cancer patients.When cancer occurs,it can promote the increase count and activation degree of platelet.In addition,mean platelet volume(MPV)is an early marker of activated platelets.Many studies have shown that MPV of cancer patients is lower than that of healthy control group,which is inversely proportional to platelet count(PC),using the ratio MPV / PC may be more sensitive to forecast the incidence of lung cancer.However,the value of MPV / PC in the diagnosis of lung cancer and the value of PLR in the prediction of the treatment efficacy of lung cancer will be discussed in detail.Objective: To analyze the influencing factors on the prognosis of targeted therapy in non-small cell lung cancer(NSCLC)patients with epidermal growth factor receptor(EGFR)mutant mutations;Explore the diagnostic value of MPV / PC combined with other lung cancer tumors markers in NSCLC.Methods: The clinical characteristics and hematological parameters of lung cancer patients before treatment were analyzed,and PLR,MPV / PC were calculated.Carcinoembryonic antigen(CEA),neuron-specific enolase(NSE),cytokeratin-19-fragment(CYFRA21-1),squamous cell carcinoma antigen(SCCA)were detected simultaneously.COX proportional hazard regression models and Kaplan-Meier survival curves were used to obtain independent prognostic factors that affect progression-free survival(PFS)and overall survival(OS)in lung cancer patients with targeted treatment.The receiver operating characteristic(ROC)curve was used to evaluate the diagnostic value of mean platelet volume / platelet count(MPV / PC)in lung cancer.Results: The results of the first part of the study: 1.The COX regression analysis showed that the main factors affecting the patient’s PFS were the degree of tumor differentiation,the level of PLR,and distant metastasis;the main factors affecting the OS of patients were the T stage of the tumor,the level of PLR,the level of CYFR21-1,and distance metastasis.There were significant differences in survival curves of PFS and OS between patients with high PLR group and patients with low PLR group,p<0.05.The mean PFS in the two groups was 6.8 months and 11.1 months,respectively.The average OS in the two groups was 17.8 months and 25.3 months,respectively.There were significant differences in OS survival curves between patients in the high CYFR21-1 group and patients in the low CYFR21-1 group,p <0.05.The average OS in the two groups was 18.38 and 22.60 months,respectively.3.PLR is closely related to distant metastasis of lung cancer,and PLR is significantly higher in patients with distant metastasis than in non-metastatic patients.The results of the second part of the study: 1.The receiver operating curve shows that the best cutoff value for MPV / PC to distinguish lung cancer from healthy people is 0.054(area under the curve [AUC] =0.797,sensitivity is 0.695,specificity is 0.876);the best cutoff value for MPV / PC to distinguish lung cancer from pneumonia is 0.054(area under the curve [AUC] = 0.818,sensitivity is 0.721,specific The degree of diagnosis is 0.691);MPV / PC has higher diagnostic value between lung cancer and pneumonia,lung cancer and healthy people,and different stages of lung cancer than MPV alone.MPV / PC combined with CEA can improve the sensitivity of lung cancer diagnosis.2.MPV / PC has a high level before treatment of lung cancer patients,and the levels decreased significantly after effective treatment.3.The decline of MPV / PC predicts the disease progression of lung cancer patients.Conclusion: The levels of PLR and CYFR21-1 before treatment are important markers that affect the prognosis of targeted therapy for patients with EGFR-mutant non-small cell lung cancer;MPV / PC is a excellent marker to distinguish lung cancer from pneumonia.