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Archive > Volume 32 Issue 2 > 2025,32(2):189-198. DOI:10.3872/j.issn.1007-385X.2025.02.007 Prev Next
Clinical Research
Prognostic value of combined NLR, PLR and LDH evaluation in immunotherapy for metastatic gastric cancer
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Abstract:
[Abstract] Objective: To explore the predictive value of combined evaluation of neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), and lactate dehydrogenase (LDH) on the therapeutic effect and prognosis of ICIs (immune checkpoint inhibitors) in metastatic gastric cancer (MGC) patients. Methods: This study conducted a retrospective analysis of pre- and posttreatment peripheral hematological indicators of 88 MGC patients treated at Nanping First Hospital affiliated to Fujian Medical University. The recent treatment efficacy of the two patient groups was evaluated based on the solid tumor response evaluation criteria. χ2 tests were conducted to analyze and compare differences in disease control rate (DCR) and objective response rate (ORR), as well as differences in PD-L1 expression and clinical characteristics between the two groups. Survival analysis was performed using the Kaplan-Meier method for univariate analysis. Intergroup differences were detected by the Log-Rank test. Univariate analysis was conducted using the Cox proportional hazards regression model. Results: After immunotherapy, NLR3, NLR4, PLR2, PLR3, PLR4, LDH2 and LDH3 decreased significantly compared with those before treatment (all P < 0.05). There were significant statistical differences in NLR1 and LDH1 before treatment between the complete-remission (CR) + partial-remission (PR) group and the progressdisease (PD) group (all P < 0.05). Patients with higher levels of NLR2, NLR3, NLR4, PLR4, LDH1, LDH3, LDH4, ΔNLR1, ΔNLR2, ΔNLR3 and ΔPLR1 had shorter OS (all P < 0.05), and patients with higher levels of NLR2, NLR3, NLR4, PLR1, LDH1, ΔNLR1, ΔNLR2, ΔNLR3, ΔPLR1 and ΔPLR2 had shorter PFS compared with patients in low-level group (all P < 0.05). The percentage of PD-L1 negative patients among NLR3-H patients was the highest, and the number of NLR3-H patients in the NLR3-L group was larger than that in the negative group, the combined positive score (CPS) =1-5 group and the CPS ≥ 5 group (all P < 0.05). The proportion of women in the NLR3-H and PLR3-H groups was higher (all P < 0.05). Conclusion: The evaluation of NLR, PLR, and LDH has certain value in predicting the efficacy and prognosis of immunotherapy for MGC.
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