D-D and PLR, NLR combined forecasting first-line treatment: The short-term curative effect and prognosis of patients with SCLC

Abstract

The aim of this study was to evaluate the difference in D-dimer (D-D) combined with the platelet lymphocyte ratio (PLR) and neutrophil-to-lymphocyte ratio (NLR) before treatment in small cell lung cancer (SCLC) patients receiving first-line treatment and to analyze the efficacy and prognosis. We retrospectively collected the records of SCLC patients treated in our hospital from February 2019 to January 2023 and finally included 100 patients. A binary logistic regression analysis method was applied to analyze the relationship between D-D, PLR, and NLR and short-term efficacy. Univariate and multivariate Cox regression analyses were utilized to estimate the individual effect of plasma parameters on progression-free survival (PFS). The optimal cutoff values of D-D, PLR, and NLR for predicting survival outcome were determined by receiver operating characteristic curve analysis. Kaplan-Meier survival analysis was utilized to examine the correlation between D-D, PLR, and NLR the prognosis of SCLC patients. PLR was associated with a short-term curative effect in patients with SCLC (odds ratio: 0.326, 95% confidence interval [CI]: 0.135 0.790). Univariate Cox regression showed that D-D (hazard ratio [HR]: 0.495, 95% CI: 0.323-0.758), PLR (HR:0.420, 95% CI: 0.269-0.655) and NLR (HR: 0.407, 95% CI: 0.263-0.630) were associated with PFS in SCLC patients (P < .05). Multivariate Cox regression analysis showed that PLR (HR: 2.395, 95% CI: 1.468-3.906) and NLR (HR: 2.148, 95% CI: 1.319-3.499) correlated significantly with PFS (P < .05). The optimal cutoff values of D-D, PLR and NLR for predicting PFS were 0.88 mg/L (65.4% and 68.7%), 195.44 (61.5% and 81.2%) and 3.63 (63.5% and 81.2%), respectively, and the corresponding area under receiver (AUC) operating characteristic curve 0.691 (95% CI: 0.587-0.795), 0.721 (95% CI: 0.620-0.822) and 0.714 (95% CI: 0.614-0.815). When D-D was used in combination with PLR or NLR, the corresponding AUCs were 0.737 (95% CI: 0.640-0.835) and 0.761 (95% CI: 0.667-0.855). Pretreatment PLR is an independent predictor of short-term efficacy in SCLC patients. Pretreatment D-D, PLR and NLR are potential biochemical markers for predicting the prognosis of SCLC patients treated with first-line treatment. When D-D is combined with PLR and NLR, it shows stronger predictive ability.