Relationship between serum cytokines,CAR,NLR,PLR and immune checkpoint inhibitor-associated pneumonia or prognosis in lung cancer patients
CHEN Huijuan
ZHANG Ying
HUANG Jing
TAN Delun
XV Hanfeng
Abstract：Objective To investigate the relationship between serum cytokine and C-reactive protein to albumin ratio(CAR),neutrophil to lymphocyte ratio(NLR),platelet to lymphocyte ratio(PLR),immune checkpoint inhibitor(ICIs)associated pneumonia(ICIaP)and prognosis in lung cancer patients.Methods Collect unresectable stage Ⅲ or Ⅳ lung cancer patients who received at least one ICIs treatment from October 2018 to December 2021.Seventy-seven patients developed ICIaP(ICIaP group),and 77 patients without ICIaP were selected as the control group.Cytokines,blood routine,CRP,and ALB at baseline(before ICIs),during ICIaP diagnosis(in the ICIaP group),and after the last ICIs(in the control group)were collected.The changes in baseline values and various blood parameters over time between two groups were compared.Follow-up data was collected and survival curves were drew.Results Logistic regression analysis showed that histological type and ICI monotherapy were independent factors affecting ICIaP.In the ICIaP group,serum interleukin(IL)-6,IL-17A,NLR,PLR,and CAR significantly increased compared to baseline at the time of diagnosis of ICIaP(P＜0.05).The serum levels of IL-6 and IL-17A in the control group decreased over time(P＜0.05),and no significant changes were observed in other indicators.When diagnosed with ICIaP,higher levels of IL-6,IL-17A,PLR,NLR,and CAR can effectively predict severe ICIaP(≥grade 3),with an area under the curve ranging from 0.712 to 0.859.The high IL-6 levels(HR=1.002,P=0.044)and high CAR(HR=1.174,P=0.049)measured at the time of diagnosis of ICIaP are associated with poor survival in ICIaP.Conclusion Serum IL-6,IL-17A,NLR,PLR,and CAR may serve as biomarkers for the early diagnosis of ICIaP and contribute to improving the risk stratification of ICIaP.Especially during the initial onset of ICIaP symptoms,high levels of IL-6 and CAR may indicate poor prognosis in lung cancer patients.
Keywords：Lung cancerImmune checkpoint inhibitorsImmune checkpoint inhibitor associated pneumoniaPrognosisSerum cytokines
Publication Date：2023-10-28
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 929-934 )