[摘 要] 目的：探讨iSEND免疫评分联合肺癌免疫治疗预后指数（LIPI）在评估非小细胞肺癌（NSCLC）接受免疫治疗预后中 的价值。方法：通过回顾性分析2018年2月至2023年2月期间100例接受免疫治疗的晚期NSCLC患者的临床资料，收集并整理 患者的iSEND免疫评分和LIPI数据，根据iSEND免疫评分和LIPI分别将患者分为3组（不良组、中等组和良好组），运用KaplanMeier方法绘制生存曲线分析所有患者和不同组别患者的无进展生存期（PFS），运用Cox回归分析评估影响患者预后的风险因 素。结果：在接受免疫治疗后，NSCLC患者的ORR为42.00%（42/100），DCR为82.00%（82/100）。iSEND免疫评分和LIPI不良 组ORR和DCR均最低，良好组均最高，不同组别ORR和DCR比较均有统计学意义（均P < 0.01）。100例NSCLC患者的中位PFS 为7.63个月[95% C（I 7.23, 8.05）]，iSEND免疫评分不良组、中等组和良好组的中位PFS分别为4.69、6.58和8.99个月，iSEND免疫 评分良好组的PFS最长，其次为中等组，不良组最短（χ2 =125.391，P < 0.000 1）。LIPI不良组、中等组和良好组的中位PFS分别为 4.54、6.39和8.49个月，以LIPI良好组的PFS最长，其次为中等组（χ2 = 115.707，P < 0.000 1）。Cox多因素分析提示，ECOG PS > 1、 远处转移、iSEND免疫评分≥ 2分和LIPI ≥ 2分是影响患者独立预后的风险因素。结论：iSEND免疫评分和LIPI可作为评估 NSCLC免疫治疗预后的良好指标，具有一定的临床价值。

[Abstract] Objective: To investigate the value of iSEND (inhaled, self-immunoregulatory, extracellular nanovesicle-based delivery) immune score combined with lung immune prognostic index (LIPI) in evaluating the prognosis of non-small cell lung cancer (NSCLC) patients undergoing immunotherapy. Methods: A retrospective analysis was conducted on the clinical data of 100 patients with advanced NSCLC who received immunotherapy from February 2018 to February 2023. The iSEND immune score and LIPI data of these patients were collected. Patients were divided into 3 groups (poor, moderate, and good) according to their iSEND and LIPI scores. Kaplan-Meier survival curves were polotted to analyze progression-free survival (PFS) among all patients and within different groups. Cox regression analysis was used to identify the risk factors affecting patient prognosis. Results: After immunotherapy, the objective response rate (ORR) was 42.00% (42/100) and the disease control rate (DCR) was 82.00% (82/100) among NSCLC patients. The ORR and DCR were lowest in the poor groups and highest in the good groups for both iSEND immune score and LIPI score, with significant differences among groups (all P < 0.01). The mPFS for all 100 NSCLC patients was 7.63 month (95% CI [7.23, 8.05]). The mPFS for the poor, moderate, and good groups in terms of iSEND immune score was 4.69, 6.58, and 8.99 months, respectively, with the good group having the longest PFS, followed by the moderate group, and the poor group (χ2 = 125.391, P < 0.000 1). Similarly, the mPFS for the poor, moderate, and good groups in terms of LIPI was 4.54, 6.39, and 8.49 months, respectively, with the good group having the longest PFS, followed by the moderate group and poor group (χ2 = 115.707, P < 0.000 1). Cox multivariate analysis identified ECOG PS > 1, distant metastasis, iSEND immune score ≥ 2, and LIPI ≥ 2 as independent risk factors affecting patient prognosis. Conclusion: iSEND immune score and LIPI can serve as valuable prognostic indicators for NSCLC patients undergoing immunotherapy, demonstrating certain clinical value.

成都市医学科研课题（No. 2021372）