Correlation between the combination of platelet-to-lymphocyte ratio and cholinesterase with prognosis in advanced non-small cell lung cancer patients undergoing first-line chemotherapy

MA Wen; CHEN Ting; CHEN Yun; ZHANG Yongjie

doi:10.3969/j.issn.1009-0460.2025.08.005

Abstract：Objective To investigate the predictive value of platelet-to-lymphocyte ratio(PLR)combined with cholinesterase(CHE)in patients with advanced non-small cell lung cancer(NSCLC)receiving first-line chemotherapy.Methods A total of 170 patients with advanced NSCLC who underwent first-line chemotherapy at Huai'an Hospital Affiliated to Xuzhou Medical University from January 2014 to December 2020 were selected as the study objects.X-tile software was used to stratify the risks of PLR and CHE and obtain the best cutoff value.Spearman correlation analysis was employed to evaluate the correlation between CHE and PLR.Kaplan-Meier method was used to compare the survival status of patients with different CHE-PLR scores and analyze the relationship between CHE,PLR,CHE-PLR scores and tumor histological types.Cox proportional hazards regression model was conducted to analyze the factors affecting patient prognosis.A nomogram model was built and its prediction efficiency was evaluated.Results CHE was negatively correlated with PLR in NSCLC patients(r=-0.354,P<0.001).The best cut-off values for CHE and PLR were 6 310 U/L and 272.4 respectively.Patients were divided into high-level group and low-level group based on the best cut-off value.According to the CHE-PLR scoring criteria,a score of 0 was assigned when CHE≥6 310 and PLR<272.4,a score of 1 was assigned when CHE<6 310 or PLR≥272.4,and a score of 2 was assigned when CHE<6 310 and PLR≥272.4.The median survival time in the high and low CHE group was 41.0 months and 16.0 months,respectively(P<0.001).The median survival time in the high and low PLR group was 14.0 months and 38.0 months,respectively(P<0.001).The median survival time of patients with CHE-PLR scores of 1 and 2 was 21.5 and 13.9 months,which was significantly shorter than 45.2 months of patients with score of 0(both P<0.001).Multivariate Cox proportional hazards regression analysis showed that age,ECOG score,carbohydrate antigen(CA)125,CHE,PLR and CHE-PLR score were independent predictors of patient prognosis(P<0.05).Based on this,a column line analysis model was established,with a consistency index(C-index)of 0.854.The discrimination and accuracy of the model with CHE-PLR scoring were better than the model without CHE-PLR scoring.Conclusion The CHE-PLR score before treatment can effectively predict the survival of patients with advanced NSCLC and can be used as an independent prognostic factor for patient prognosis.