目的 探讨淋巴细胞与 C 反应蛋白比值(LCR)在非小细胞肺癌(NSCLC)患者预后中的价值。 方法 选取 2016 年 1 月至 2019 年 10 月苏州大学附属第一医院和苏州大学附属第二医院肿瘤科和呼吸科确诊 NSCLC 的患者 422 例,以结果为导 向的方法确定最合适的 LCR 截断点,将患者分为高 LCR 组与低 LCR 组。 Kaplan-Meier 法构建生存曲线,Log-rank 检验评估 组间差异,并根据肿瘤组织学类型(鳞癌和腺癌)以及 TNM 分期(Ⅰ~Ⅲ期和Ⅳ期)进行分层分析。 使用 Cox 比例风险回归模 型计算风险比(HR)和 95%CI。 此外,根据患者特征进行亚组分析和交互作用分析,Cox 相乘交互作用分析患者不同特征与 LCR 的交互作用对 NSCLC 患者预后的影响。 结果 Kaplan-Meier 分析显示,高 LCR 患者总生存率显著升高(P<0. 001);按肿 瘤组织学类型及 TNM 分期分层后,高 LCR 的患者总生存期仍显著增加(P<0. 001)。 多因素 Cox 比例风险回归模型分析显 示,与低 LCR 比较,高 LCR 组(HR= 0. 45, 95%CI = 0. 34~ 0. 61, P<0. 001)患者的预后良好;性别(P= 0. 012)、吸烟(P= 0. 002) 及组织学类型(P= 0. 012) 与 LCR 存在交互作用,即高 LCR 是男性、曾经/ 目前吸烟者、鳞癌或腺癌患者预后良好的指标。 结论 高 LCR 水平与 NSCLC 患者预后良好有关,LCR 可作为预测 NSCLC 患者预后稳定且有用的生物标志物。

Objective Systemic inflammatory response is closely related to tumor progression. We aimed to investigate the prognostic value of ratio of lymphocyte to C-reactive protein ratio LCR for overall survival OS in patients with non-small cell lung cancer NSCLC . Method 422 NSCLC patients were enrolled in this study. An outcome-oriented Method was used to determine the most appropriate cut - off value of LCR. The participants were divided into two groups a low - LCR group and a high - LCR group. Survival curves were generated using the Kaplan-Meier Method and compared using the log-rank test. We performed subgroup analysis according to histological type adenocarcinoma vs squamous cell carcinoma and TNM stage Ⅰ-Ⅲ vs Ⅳ . Cox proportional hazard regression model was used to calculate hazard ratio HR and 95% confidence interval CI . Moreover We performed subgroup analysis and interaction analysis based on patient characteristics and Cox product interaction analysis to investigate the impact of the interaction between patient characteristics and LCR on the prognosis of NSCLC patients. Result The Kaplan-Meier analysis revealed that patients with high LCR had significantly improved OS P<0. 001 . Patients with high LCR also showed a significantly improved OS P<0. 001 after stratified by histological type and TNM stage. The Cox multivariate analysis showed that patients with high LCR HR= 0. 45 95%CI = 0. 34-0. 61 P<0. 001 had favorable prognoses when compared with those with the lowest LCR. Gender P = 0. 012 smoking P= 0. 002 and histological type P = 0. 012 significantly interacted with LCR indicating that high LCR was a good indicator for male former/ current smokers squamous carcinoma or adenocarcinoma patients. Conclusion High LCR may be associated with a favorable prognosis in NSCLC patients.