ABSTRACT
Objective To investigate the value of platelet-to-lymphocyte ratio (PLR) and cell proliferation antigen Ki-67 in judging the chemotherapy efficacy and prognosis of patients with advanced non-small cell lung cancer (NSCLC). Methods The clinical data of 132 patients with advanced NSCLC diagnosed by pathology and immunohistochemistry from January 2015 to January 2016 in Shanxi Provincial Cancer Hospital were retrospectively analyzed. Peripheral venous blood cells were collected before chemotherapy, the platelet and lymphocyte counts were detected by using blood cell analyzer to calculate PLR. Immunohistochemical SP method was used to detect the expression of Ki-67 in tissue sections. The platinum-containing dual-drug regimen was used in the first-line chemotherapy for at least 4 cycles. The χ2 test was used to compare the count data, and the logistic regression model was used to analyze the factors affecting the effective rate. The Kaplan-Meier method and log-rank test were used for survival analysis, and the Cox proportional hazards regression model was used for multivariate analysis of prognosis. Results The total effective rate of the first-line chemotherapy was 41.7％ (55/132). The 1-year and 2-year overall survival (OS) rates were 26.1％ and10.4％, respectively. and the mean progression-free survival (PFS) time was 5.7 months (95％ CI 3.2-10.9 months) and the median OS time was 14.05 months (95％ CI 6.8-18.4 months). The median PLR was 172.0. The effective rate in PLR < 172.0 group was higher than that in PLR≥172.0 group [60.6％ (40/66) vs. 22.7％(15/66), χ 2 = 19.481, P < 0.05], and the median OS time in PLR < 172.0 group was longer than that in PLR≥172.0 group (17.6 months vs. 15.0 months, χ 2 = 4.976, P < 0.05), and there was no significant difference in the median PFS time between the two groups (8.6 months vs. 6.5 months, χ 2 = 0.078, P > 0.05). There was no significant difference in the effective rate between Ki-67 negative group and positive group [40.0％ (28/70) vs. 43.5％ (27/62), χ 2 = 0.170, P > 0.05]. The median PFS time and OS time in Ki-67 negative group were longer than those in positive group (7.6 months vs. 6.5 months, χ 2 = 7.170, P < 0.05; 18.3 months vs. 14.5 months,χ 2 = 15.870, P < 0.05). According to the results of multivariate analysis, PLR was an effective independent factor for effective rate (P < 0.05), Ki-67 was an independent influencing factor for PFS (P < 0.05), and PLR and Ki-67 were independent influencing factors for OS (P < 0.05). Conclusion PLR and Ki-67 can be used as meaningful indicators for predicting the chemotherapy efficacy and prognosis of advanced NSCLC.
ABSTRACT
Objective To investigate the significance of resistant gene detection combined with adenosine triphosphate-tumor chemosensitivity assay (ATP-TCA) in the second-line chemotherapy of lung squamous cell cancer, and to provide a reference for clinical treatment. Methods 150 patients with lung squamous cell cancer diagnosed by histopathology or cytology and with the disease progressed after NP regime chemotherapy were enrolled. The mRNA expressions of excision repair cross complementation 1 (ERCC1) and ribonucleotide reductase M1 (RRM1) were detected by RT-PCR, and ATP-TCA was carried out. After detected by RT-PCR and ATP-TCA, the patients who were sensitive to gemcitabine plus cisplatin (GP) accepted the second-line systemic chemotherapy with GP regimen, and the others who were not sensitive to GP regimen or whose results of gene detection and ATP-TCA were on the contrary took the second-line chemotherapy regimens with docetaxel plus cisplatin (DP). Both groups accepted 2-4 cycles of systemic chemotherapy. The chest CT was followed up, and the response rate (RR), progression-free survival (PFS) and median survival time (MST) were investigated. Results The RR of GP group was 36.2 % (17/47), while the DP group was 28.1 % (26/92), and the difference was statistically significant (χ2= 4.274, P 0.05). Conclusion The resistance gene detection combined with ATP-TCA have certain guiding significance on the second-line chemotherapy for advanced lung squamous cell cancer.