全身性炎症在肿瘤发生中发挥作用，并与不同癌症类型的患者的总体生存相关，包括那些接受免疫检查点阻断治疗（ICB）的患者。中性粒细胞-淋巴细胞比值（NLR）通过循环中性粒细胞与淋巴细胞计数计算而得，代表中性粒细胞增多的有害作用和淋巴细胞介导的免疫反应有益作用之间的平衡指标。我们假设NLR可能预测转移性结直肠癌（mCRC）患者免疫治疗的预后。本回顾性研究纳入了110例在中山大学肿瘤医院接受免疫治疗的mCRC患者。在基线和两个疗程后测量了多个炎症生物标志物。使用X-tile程序获得了截断值。我们研究了基线和治疗后炎症指标水平对总体生存（OS）的影响。在单变量分析中，低基线NLR（P = 0.014）和免疫治疗2个疗程后NLR的降低（P < 0.001）与更好的OS显著相关。在多因素分析中，年龄、肝转移、基线淋巴细胞单核细胞比（LMR）、基线NLR和NLR的早期变化独立预测了OS。基线NLR低和早期NLR减少的患者具有最长的OS（中位数为29.63个月）。同时，早期NLR降低和高肿瘤突变负荷（TMB）（≥10个突变/兆碱基对，mut/Mb）的患者显示出最佳预后（P < 0.0001）。在接受免疫治疗的mCRC患者中，低基线NLR和早期NLR降低与更好的预后显著相关。进一步分析表明，NLR和TMB的组合能够获得额外的预测能力。版权所有 © 2023作者。由Elsevier B.V.出版。保留所有权利。

Systemic inflammation plays a role in carcinogenesis and is related to overall survival in patients with different cancer types, including those treated with immune checkpoint blockade (ICB). The neutrophil-lymphocyte ratio (NLR) is calculated by circulating neutrophil to lymphocyte counts, which represents an indicator of the balance between the deleterious roles of neutrophilia and the beneficial roles of lymphocyte-mediated immunity. We hypothesized that the NLR may predict outcomes in metastatic colorectal cancer (mCRC) patients treated with immunotherapy.This retrospective study included 110 mCRC patients who were treated with immunotherapy at Sun Yat-sen University Cancer Center. Several inflammatory biomarkers were measured at baseline and after two cycles of treatment. The X-tile program was used to obtain the cutoff values. We examined the impact of both baseline and posttreatment inflammatory index levels on overall survival (OS).In univariate analysis, both a low baseline NLR (P = 0.014) and a decreased NLR after 2 cycles of immunotherapy (P < 0.001) were considerably correlated with better OS. In multivariate analysis, age, liver metastasis, baseline lymphocyte-monocyte ratio (LMR), baseline NLR and early changes in NLR independently predicted OS. Patients with both a low baseline NLR and an early NLR reduction had the longest OS (median, 29.63 months). The best outcomes were remarkably observed in patients who had both an early NLR reduction and a high tumor mutational burden (TMB) (≥10 mut/Mb) (P < 0.0001).Both a low baseline NLR and an early NLR reduction are significantly associated with a better prognosis in mCRC patients treated with immunotherapy. Further analysis indicated that the combination of NLR and TMB could obtain additional predictive power.Copyright © 2023 The Authors. Published by Elsevier B.V. All rights reserved.