ABSTRACT
Objective To investigate the predictive and guiding significance of peripheral blood biomarkers on the therapeutic effects of PD-1/PD-L1 inhibitor treatment on lung cancer patients. Methods We collected the data of 200 lung cancer patients treated with PD-1/PD-L1 inhibitors treatment, including clinical indicators, peripheral blood indicators, efficacy indicators and survival indicators. Results The DCR of patients with non-hepatic metastasis, immune combined chemotherapy, NLR≤2.81 and LDH≤202.5 u/L was higher (P < 0.05). The AUC value of NLR combined with LDH predicting DCR was 0.698 (P < 0.05). Univariate analysis showed that non-hepatic metastasis, first-line immunotherapy, immunotherapy combined with chemotherapy and LDH≤202.5 u/L were related to PFS (P < 0.05). Multivariate analysis showed that the patients with non-hepatic metastasis and LDH≤202.5 u/L had longer PFS (P < 0.05). The significant decrease of NLR and LDH after two cycles of immunotherapy indicated the effectiveness of immunotherapy (P < 0.05). Conclusion NLR≤2.81, LDH≤202.5 u/L, non-hepatic metastasis and immunotherapy combined chemotherapy are positively correlated with immunotherapy efficacy. Non-hepatic metastasis and LDH≤202.5 u/L are independent prognostic factors of the patients treated with immunotherapy. The changes of peripheral blood NLR and LDH are related to the efficacy of PD-1/PD-L1 inhibitors treatment.
ABSTRACT
Objective To summarize the diagnosis and treatment experience for patients with appendiceal carcinoid tumors.Methods 21 patients with appendix carcinoid tumors were admitted and received surgery from 1967 to 1997 in our hospital.Results 12 patients (57%) presented with signs and symptoms suggestive of acute appendicitis.In 9 patients(43%) tumors were discovered incidentally.The tumors were at the tip in 17 patients,at the middle third in 3,and at the base of the appendix in one.The tumor was less than 1 cm in diameter in 16 patients,between 1 and 2 cm in 3 patients,and larger than 2 cm in 2 patients.Tumor invasion was confined to the submucosa or muscle layers in 15 patients,serosa involved in 4 patients,and into the meso appendicular fat in the remaining 2 patients.Twenty patients underwent appendectomy alone.One patient with a tumor size larger than 2 cm and positive lymph nodes in the mesoappendix underwent secondary right hemicolectomy.Complete follow up was achieved in 19 patients,and all patients remained free of tumor recurrence and metastasis.Conclusion Appendiceal carcinoids of less than 1 cm could be adequately managed by appendectomy alone.The appropriate treatment for tumors of 1 to 2 cm are still controversial.Right hemicolectomy is recommended for tumors larger than 2 cm .