以铂类为基础的化疗是小细胞肺癌一线治疗方案,近年来免疫治疗在肺癌领域发展迅速,为小细胞肺癌患者带来 了福音。 然而,目前小细胞肺癌患者的免疫治疗应答率和应答持续时间仍不理想,主要原因是使用的预测小细胞肺癌免疫治 疗疗效的生物标志物大都存在敏感度低、特异度弱等不足,因此,临床上迫切需要筛选更高效的生物标志物。 免疫检查点相 关标志物如程序性死亡受体-配体 1 和 B7-H3 的研究显示,免疫检查点蛋白的表达水平在部分患者中与免疫治疗反应密切相 关。 肿瘤特异性标志物方面,肿瘤突变负荷作为预测免疫治疗疗效的重要指标被广泛应用,同时基于分子分型的小细胞肺癌 亚型研究也为优化治疗方案提供了新思路。 此外,肿瘤微环境相关标志物如炎症 T 细胞基因表达谱和肿瘤浸润淋巴细胞为 评估免疫反应提供了更多可能性。 在非侵入性检测领域,外周血标志物如中性粒细胞/ 淋巴细胞比值和肺免疫预后指数已显 示出良好的疗效预测能力。 本文综述了近年来小细胞肺癌领域中有发展潜力的生物标志物的研究进展,以期探讨合适的生 物标志物筛选出持久受益人群,实现个体化精准治疗,提高患者生活质量,延长生存时间。

Platinum-based chemotherapy has long been the standard first -line treatment for small cell lung cancer. In recent years immunotherapy has rapidly advanced in the field of lung cancer offering new hope for small cell lung cancer patients. However the response rate and duration of response to immunotherapy remain suboptimal primarily due to the limitations of current biomarkers for predicting immunotherapy efficacy in small cell lung cancer such as low sensitivity and weak specificity. therefore there is an urgent clinical need to identify more efficient biomarkers. The research on immune checkpoint-related markers such as PD-L1 and B7-H3 has shown that the expression levels of immune checkpoint proteins are closely related to the response to immunotherapy in some patients. In terms of tumor-specific biomarkers tumor mutation burden TMB has been widely utilized as a key indicator for predicting the efficacy of immunotherapy while molecular subtyping of small cell lung cancer offers new perspectives for optimizing treatment strategies. Furthermore tumor microenvironment - related biomarkers including the inflammatory T cell gene expression profile T cell inf GEP and tumor - infiltrating lymphocytes TILs provide additional possibilities for evaluating immune responses. In the field of non-invasive testing peripheral blood biomarkers such as the neutrophil-to-lymphocyte ratio NLR and lung immune prognostic index LIPI have demonstrated promising predictive value for therapeutic outcomes. This article reviews the research progress of potential biomarkers in the field of small cell lung cancer in recent years aiming to explore suitable biomarkers for identifying patients who will derive long-term benefit realizing individualized precision treatment improving patients' quality of life and prolonging survival time.