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Objective:To explore the predictive value of neutrophil to lymphocyte ratio (NLR) and systemic immune-inflammation index (SII) of inflammatory markers of peripheral blood cells on the prognosis in the advanced non-small cell lung cancer (NSCLC) patients with immune therapy.Methods:The hematologic and clinical data of 58 patients with advanced non-small cell lung cancer who received the treatment of immune therapy in the First People's Hospital of Chuzhou of Anhui Province from January 2018 to June 2022 were retrospectively analyzed. X-tile software was used to calculate the optimal cut-off values of NLR and SII. All patients were divided into high and low groups according to the optimal cut-off values. The relationship between different NLR, SII and clinicopathological features, clinical efficacy, prognosis of the advanced non-small cell lung cancer patients with immune therapy were analyzed. Cox regression models were used to perform univariate and multivariate analyses of factors affecting patient prognosis.Results:The optimal cut-off values for NLR and SII were 3.2 and 546.5, respectively. There were statistically significant differences in regional lymph node metastasis ( χ2=5.03, P=0.025) and the number of metastatic sites ( χ2=11.60, P=0.001) between patients in the low-NLR group (NLR<3.2, n=26) and the high-NLR group (NLR≥3.2, n=32). There were statistically significant differences in location of the primary site ( χ2=8.34, P=0.004) between patients in the low-SII group (SII<546.5, n=28) and the high-SII group (SII≥546.5, n=30). The objective response rate (ORR) of the low-NLR group [50.00% (13/26) ] was higher than that of the high-NLR group [21.88% (7/32) ], and there was a statistically significant difference ( χ2=5.02, P=0.025) ; the disease control rate (DCR) of the low-NLR group [69.23% (18/26) ] was higher than that of the high-NLR group [50.00% (16/32) ], but there was no statistically significant difference ( χ2=2.19, P=0.139). The ORR of the low-SII group [53.57% (15/28) ] was higher than that of the high-SII group [26.67% (8/30) ]; The DCR of the low-SII group [67.86% (19/28) ] was higher than that of the high-SII group [33.33% (10/30) ], and there were statistically significant differences ( χ2=4.38 , P=0.036; χ2=6.91 , P=0.009). The median overall survival (OS) of patients in the low-NLR group (17.6 months) was longer than that of the high-NLR group (11.7 months), and there was a statistically significant difference ( χ2=11.07, P=0.001). The median OS of patients in the low-SII group (16.5 months) was longer than that of the high-SII group (12.3 months), and there was a statistically significant difference ( χ2=5.53, P=0.019). Univariate analysis showed that Eastern Cooperative Oncology Group (ECOG) score ( HR=2.20, 95% CI: 1.10-4.39, P=0.025), brain metastases ( HR=3.24, 95% CI: 1.61-6.50, P=0.001), the number of transferred sites ( HR=2.83, 95% CI: 1.44-5.57, P=0.003), NLR ( HR=3.22, 95% CI: 1.56-6.66, P=0.002) and SII ( HR=2.18, 95% CI: 1.12-4.24, P=0.021) were all independent influence factors affecting the prognosis of the advanced non-small cell lung cancer patients with immune therapy; multivariate analysis showed that brain metastases ( HR=2.91, 95% CI: 1.22-6.94, P=0.016), NLR ( HR=2.88, 95% CI: 1.17-7.13, P=0.022) and SII ( HR=3.63, 95% CI: 1.40-9.39, P=0.008) were all independent risk factors affecting the prognosis of the advanced non-small cell lung cancer patients with immune therapy. Conclusion:NLR and SII can be used as important indicators for predicting the efficacy of immunotherapy in the advanced NSCLC and elevated NLR and SII can indicate poor prognosis of patients.
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Objective To analyze clinical pathological characteristics of gastric cancer in elderly people,and to study the characteristics of gastric cancer incidence.Methods A retrospective analysis of clinical data of gastric cancer in elderly people which were diagnosed by gastroscopy and pathology from 2003 to 2008 was undertaken,and compared to it in young people at the same period about gender,clinical symptoms,lesion,pathological types.Results There were 70 cases of men(77.8%)and 20 cases of woman(22.2%)in elderly group,but there were 3 cases of man(25.0%)and 9 cases of woman(75.0%)in young group,there wsa significant difference between two group(P ＜0.01);The first symptoms in elderly group and young group were loss of appetite(50 cases,55.6% and 1 case,8.3%),thin and weak(38 cases,42.2% and 1 case,8.3%).difficulty swallowing(23 cases,25.6% and o case),anehia(29 cases ,32.2% and 2 cases,16.7%),upper abdominal pain(34 cases,37.1 % and 4 cases,33.3%)re spedtively.There was no significant difference between two group(P ＞ 0.05).The lesion of gastric cancer in two group were funds of stomach and cardia(39 cases,43.3% and 1 case,8.3%),antral(26 cases,28.9% and 7 cases,58.3%).body of stomach(22 cases,24.4% and 4 cases,33.3%).entire stomach(3 cases,3.3% and 0 case)respectively.There was significant difference between two group(P ＜0.05).The main of pathological types was abeno carcinoma.and the main in elderly group was moderate,high differentiation(85%),and the main in young group was moderate,low differentiation(59%).There was significant difference between two group(P ＜ 0.05).Conclusions The symptoms of gastric cancer in elderly people was non-specific,and it had more complications.We found that early diagnosis of gastric cancer in elderly people was difficult and it had poor prognosis.