Prognostic Value of Serum hs-CRP/ALB,hCAP18,and miR-214 in Predicting the Prognosis of Advanced NSCLC Patients Treated with PD-1 Inhibitor Therapy

LI Zhuoran; HUO Tingting; WANG Luonan

doi:10.3969/j.issn.1004-437X.2025.11.013

Abstract：Objective To investigate the prognostic value of serum high-sensitivity C-reactive protein(hs-CRP)/albumin(ALB),antimicrobial peptide human cationic antimicrobial protein 18(hCAP18),and microRNA-214(miR-214)in predicting the prognosis of patients with advanced non-small cell lung cancer(NSCLC)receiving programmed death receptor-1(PD-1)inhibitor therapy.Methods A total of 114 patients with advanced NSCLC at the First Affiliated Hospital of Xinxiang Medical College from January 2021 to January 2023 were selected,all of whom received PD-1 inhibitor combined chemotherapy and were divided into an effective group(83 cases)and an ineffective group(31 cases)according to the treatment prognosis.The clinical data,serum hs-CRP/ALB,hCAP18,miR-214 levels of patients in the two groups were compared,and the hs-CRP/ALB,hCAP18,miR-214 levels of patients with different pathologic features were compared.The relationship between serum hs-CRP/ALB,hCAP18,miR-214 and pathological characteristics and treatment prognosis was analyzed.The value of serum hs-CRP/ALB,hCAP18,and miR-214 in predicting the prognosis of treatment for advanced NSCLC was analyzed by receiver operating characteristic(ROC)curve.Results There were significant differences in clinical stage,lymph node metastasis,and differentiation degree between the two groups of patients(P＜0.05).The levels of serum hs-CRP/ALB,hCAP18 and miR-214 in the ineffective group were higher than those in the effective group,and the differences were statistically significant(P＜0.05).There were significant differences in hs-CRP/ALB,hCAP18,and miR-214 between patients with different pathological characteristics(P＜0.05).Spearman correlation analysis showed that the levels of serum hs-CRP/ALB,hCAP18,and miR-214 were positively correlated with clinical stage and lymph node metastasis(r=0.702,0.685,0.713,0.704,0.662,0.706,P＜0.05),and negatively correlated with differentiation degree(r=-0.693,-0.641,-0.701,P＜0.05).Partial correlation analysis showed that serum hs-CRP/ALB(95％CI:0.611-0.908),hCAP18(95％CI:0.603-0.952),and miR-214(95％CI:0.554-0.874)were independently associated with the prognosis of PD-1 inhibitor therapy in patients with advanced NSCLC(P＜0.05).The area under the curve(AUC)of serum hs-CRP/ALB,hCAP18,and miR-214 alone and in combination for predicting the prognosis of PD-1 inhibitor treatment in advanced NSCLC patients was 0.817,0.819,0.764,and 0.932,respectively.The AUC of combined prediction was the highest,with a sensitivity of 83.87％and a specificity of 85.54％.Conclusion The high expression of hs-CRP/ALB,hCAP18,and miR-214 in advanced NSCLC patients is associated with clinical stage,lymph node metastasis,differentiation degree,and PD-1 treatment prognosis,and can be used to assist in evaluating the prognosis of PD-1 inhibitor treatment in advanced NSCLC patients.