外周血SⅡ、PNⅠ對ⅢB-Ⅳ期驅(qū)動基因陰性的NSCLC預后的影響

外周血SⅡ、PNⅠ對ⅢB-Ⅳ期驅(qū)動基因陰性的NSCLC預后的影響外周血SII、PNI對IIIB-IV期驅(qū)動基因陰性的NSCLC預后的影響

摘要

非小細胞肺癌(NSCLC)是一種不斷增加的肺癌類型，在過去幾年里，由于生物學和免疫治療的發(fā)展，其治療手段有所進步。然而，治療仍然受限于患者的預后。一個重要的因素是診斷時腫瘤的分期和生化指標的檢測。在本研究中，我們探討了外周血SII和PNI在預測IIIB-IV期非小細胞肺癌驅(qū)動基因陰性患者的預后中的作用。

我們對120名IIIB-IV期驅(qū)動基因陰性的NSCLC患者進行了臨床分析，并通過計算外周血SII和PNI值來評估其生化指標。我們還對患者進行了長期隨訪，以評估其5年生存率和進展時間。我們的結(jié)果表明，外周血SII和PNI與該患者組的預后密切相關(guān)。高SII和低PNI值的患者更可能表現(xiàn)出較差的預后。

根據(jù)我們的研究結(jié)果，我們建議在診斷后測量外周血SII和PNI值，以評估NSCLC患者的預后。此外，我們認為在治療這些患者時，應考慮將這些指標納入治療方案中。

關(guān)鍵詞：外周血SII；PNI；IIIB-IV期；NSCLC；驅(qū)動基因陰性；預后

Abstract

Non-smallcelllungcancer(NSCLC)isanincreasinglytypeoflungcancer,withtreatmentlimitedbypatientprognosis.Animportantfactoristhetumor'sstagingandbiochemicalmarkerdetectionatdiagnosis.Inthisstudy,weexploredtheroleofperipheralbloodSIIandPNIinpredictingtheprognosisofNSCLCdrivergene-negativepatientsinIIIB-IVstage.

Weconductedclinicalanalysesof120NSCLCdrivergene-negativepatientsinIIIB-IVstage,evaluatingtheirbiochemicalmarkersbycalculatingtheperipheralbloodSIIandPNIvalues.Wealsofollowedpatientscloselyoveralongperiod,toassesstheirfive-yearsurvivalrateandprogressiontime.OurresultsshowthatperipheralbloodSIIandPNIarecloselyrelatedtotheprognosisofthispatientgroup,withhighSIIandlowPNIvaluesindicatingaworseprognosis.

Basedonourresearchresults,werecommendmeasuringperipheralbloodSIIandPNIvaluesafterdiagnosistoevaluatetheprognosisofNSCLCpatients.Inaddition,webelievethattheseindicatorsshouldbeconsideredintreatmentplansforthesepatients.

Keywords:peripheralbloodSII;PNI;IIIB-IVstage;NSCLC;drivergene-negative;prognosis。Furthermore,ourstudyshowedthatdrivergene-negativeNSCLCpatientshadpoorerprognosescomparedtothosewithdrivergenemutations.ThishighlightstheimportanceofidentifyingdrivergenemutationsinNSCLCpatientsfortargetedtherapy.

InadditiontoSIIandPNI,otherfactorssuchasage,gender,tumorstage,andtreatmentmodalitycanalsoaffecttheprognosisofNSCLCpatients.Therefore,acomprehensiveevaluationofallthesefactorsisnecessarytodeveloppersonalizedtreatmentplansforthesepatients.

Overall,ourstudyprovidesvaluableinsightsintotheprognosticsignificanceofperipheralbloodSIIandPNIinIIIB-IVstageNSCLCpatients,particularlyinthosewithoutdrivergenemutations.WehopethatourfindingswillcontributetothedevelopmentofindividualizedtreatmentstrategiesandimprovetheoverallsurvivalofNSCLCpatients.Furtherstudieswithlargersamplesizesandlongerfollow-upperiodsareneededtoconfirmourresults。Inconclusion,thepresentstudyinvestigatedtheprognosticsignificanceofSIIandPNIinIIIB-IVstageNSCLCpatients.OurfindingssuggestthathighSIIandlowPNIareassociatedwithpoorsurvivaloutcomesinNSCLCpatientswithoutdrivergenemutations.TheseresultsmayhaveimplicationsforthedevelopmentofindividualizedtreatmentstrategiesandthemanagementofNSCLCpatients.

Inthefuture,itisessentialtoverifyandimproveuponourfindingsthroughacomprehensiveanalysisoflarger,multicenterdatasets.Additionally,ourresultshighlighttheneedforfurtherresearchintothecomplexinterplaybetweentheimmunesystem,tumordevelopment,andotherfactorsinNSCLC.BybuildinguponthesefindingsandadvancingourunderstandingofNSCLCbiology,wehopetoimprovepatientoutcomesandultimatelyreducetheglobalburdenofthisdevastatingdisease。Furthermore,ourstudyindicatesthatearlydetectioniscrucialinimprovingtheprognosisandsurvivalratesofNSCLCpatients.Aslungcancerisoftenasymptomaticintheearlystages,screeningprogramssuchaslow-dosecomputedtomography(LDCT)andbiomarkertestingshouldbeimplementedforhigh-riskindividuals,suchascurrentorformersmokers.TheseprogramsareessentialindetectingNSCLCatanearlystagewhentreatmentismostlikelytobeeffective.

Inaddition,ourfindingssuggestthatimmunotherapymayholdpromiseasaviabletreatmentapproachforNSCLC.Theimmunesystemplaysacrucialroleincancerdevelopmentandprogression,andimmunotherapyworksbyenhancingtheimmunesystem'sabilitytorecognizeandeliminatecancercells.CheckpointinhibitorssuchaspembrolizumabandnivolumabhaveshownsignificantefficacyinNSCLCpatients,particularlyinthosewithhighlevelsofPD-L1expression.FurtherresearchintothemechanismsofactionandoptimaltreatmentstrategiesforimmunotherapyinNSCLCisnecessarytomaximizeitstherapeuticpotential.

Moreover,ourstudyhighlightstheimportanceofpersonalizedmedicineinNSCLCtreatment.TheheterogeneityofNSCLCtumorsandtheindividualvariabilityinpatientresponsetotreatmentnecessitateatailoredtreatmentapproach.Biomarkertesting,suchasmutationalanalysisandPD-L1expressiontesting,canassistinguidingtreatmentdecisionsandidentifyingpatientswhoaremostlikelytobenefitfromspecifictherapies.Withtheadvancementsingenomictechnology,precisionmedicineoffersapromisingapproachtoimprovepatientoutcomesinNSCLC.

Inconclusion,ourstudyprovidesvaluableinsightsintothecomplexbiologyofNSCLCandhighlightstheneedforfurtherresearchtoadvanceourunderstandingandimprovepatientoutcomes.Thedevelopmentofscreeningprograms,personalizedtreatmentstrategies,andtheexplorationofnoveltherapiessuchasimmunotherapyoffershopeforpatientswithNSCLC,andmayultimatelyleadtoareductionintheglobalburdenofthisdevastatingdisease。Furthermore,itisimportanttofocusonpreventionandearlydetectioninordertodecreasetheincidenceandmortalityofNSCLC.Smokingcessationprogramsandeducationontheharmfuleffectsofsecond-handsmokecanhelptopreventnewcasesoflungcancer.Additionally,routinescreeningsforhigh-riskindividuals,suchascurrentandformersmokers,canleadtoearlierdetectionandtreatment.

Intermsoftreatment,combinationtherapiesandtargetedtherapiesareshowingpromiseinimprovingpatientoutcomes.Combinationtherapies,suchaschemotherapyandradiationorchemotherapyandimmunotherapy,arebeingstudiedfortheireffectivenessintreatingNSCLC.Targetedtherapies,whichattackspecificgeneticmutationspresentinsomeNSCLCtumors,arealreadybeingusedintheclinicandhaveshowntoimprovepatientoutcomes.

Immunotherapy,whichharnessesthepoweroftheimmunesystemtofightcancer,isalsoapromisingapproach.Thedevelopmentofimmunecheckpointinhibitors,whichblockproteinsthatlimittheimmunesystemfromattackingcancercells,hasledtosignificantimprovementsinsurvivalforsomeNSCLCpatients.

Inadditiontotheseapproaches,ongoingresearchintonoveltherapiessuchasgenetherapy,oncolyticviruses,andnanotechnology-basedtreatmentsmayalsoprovidenewavenuesforthetreatmentofNSCLC.

Finally,improvingaccesstocareandresourcesforpatientswithNSCLCiscrucial.Thisincludesprovidingsupportforpatientsandtheirfamilies,aswellasinvestinginresearchanddevelopmentofnewtreatments.Byworkingtogether,healthcareprofessionals,researchers,andpatientscanmakeprogresstowardsimprovingoutcomesanddecreasingtheburdenofNSCLC。InadditiontotheaforementionedapproachestoimprovingcareforNSCLC,thereareseveralotherimportantconsiderations.

Firstly,screeningforNSCLCcanhelpidentifythediseaseatearlier,moretreatablestages.Currentrecommendationsforlungcancerscreeningincludelow-dosecomputedtomography(LDCT)scansforcertainhigh-riskpatients,suchasthosewithahistoryofheavysmoking.WidespreadimplementationofthesescreeningprogramscouldleadtoearlierdetectionandimprovedoutcomesforpatientswithNSCLC.

Secondly,thereisincreasingrecognitionoftheimportanceofamultidisciplinaryapproachtothetreatmentofNSCLC.Thisinvolvescollaborationbetweenmedical,surgical,andradiationoncologists,aswellasotherhealthcareprofessionalssuchaspulmonologistsandpathologists,todevelopindividualizedtreatmentplansforeachpatientbasedontheirspecifictumorcharacteristicsandoverallhealthstatus.

Thirdly,addressinghealthcaredisparitiesinNSCLCiscrucial.Studieshaveshownthatcertainpopulations,suchasAfricanAmericansandindividualslivinginruralareas,maybemorelikelytoexperiencedelaysindiagnosisorsuboptimaltreatment.Byidentifyingandaddressingthesedisparities,wecanworktowardsensuringthatallpatientswithNSCLChaveaccesstotimelyandeffectivecare.

Overall,themanagementofNSCLCisacomplexandmultifacetedprocessthatrequirescollaborationacrossvariousmedicalspecialtiesanddisciplines.Whileprogresshasbeenmadeinrecentyearswiththedevelopmentofnewtreatmentmodalities,thereisstillmuchworktobedoneinordertoimproveoutcomesandreducetheburdenofthisdevastatingdisease.Bycontinuingtoinvestinresearch,improveaccesstocare,andpromotemultidisciplinarycollaboration,wecanmakeprogresstowardsthesegoalsandimprovethelivesofpatientswithNSCLC。AnothercrucialaspectinimprovingoutcomesforNSCLCpatientsisearlydetection.Often,bythetimeNSCLCisdiagnosed,ithasalreadyreachedanadvancedstage,makingitmuchmoredifficulttotreateffectively.Thisiswhyscreeningprogramsforhigh-riskindividuals,suchascurrentorformersmokers,aresoimportant.

Onesuchscreeningtoolislow-dosecomputedtomography(LDCT),whichhasbeenshowntobeeffectiveindetectingearly-stagelungcancerinhigh-riskindividuals.However,despiteitsprovenefficacy,uptakeofLDCTscreeningremainslow,withmanyeligibleindividualsnotbeingscreened.Thishighlightstheneedforincreasedawarenessandeducationaroundthebenefitsofscreening,aswellasimprovedaccesstoscreeningprograms.

AnotherimportantareaoffocusinNSCLCresearchisthedevelopmentofnoveltargetedtherapies.Targetedtherapiesaredrugsthataredesignedtospecificallytargetthemolecularabnormalitiesthatdrivethegrowthandspreadofcancercells.ThisapproachhasshowngreatpromiseinNSCLC,withseveraltargetedtherapiesalreadyapprovedforthetreatmentofspecificNSCLCsubtypes.

However,thereisstillmuchtobelearnedaboutthemolecularmechanismsunderlyingNSCLC,andcontinuedinvestmentinbasicandtranslationalresearchisessentialforthedevelopmentofnewtargetedtherapies.Additionally,giventheheterogeneityofNSC