NLR、PLR与PD-1/CTLA-4抗体联合化疗及贝伐珠单抗一线治疗复发/转移性宫颈癌患者的临床疗效关系分析

袁佳; 李馨; 吴丹妮; 沈齐; 罗晓清; 向阳; 曾玉婷; 李利波

doi:10.13406/j.cnki.cyxb.004173

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NLR、PLR与PD-1/CTLA-4抗体联合化疗及贝伐珠单抗一线治疗复发/转移性宫颈癌患者的临床疗效关系分析

肿瘤精准医学与转化研究 | 更新时间：2026-10-26

- NLR、PLR与PD-1/CTLA-4抗体联合化疗及贝伐珠单抗一线治疗复发/转移性宫颈癌患者的临床疗效关系分析
- Association of neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio with the clinical efficacy of programmed cell death protein-1/cytotoxic T-lymphocyte-associated antigen-4 antibody combined with chemotherapy and bevacizumab as a first-line treatment for patients with recurrent/metastatic cervical cancer
- 重庆医科大学学报 2026年51卷第10期页码：1441-1451
- 作者机构：
  
  贵州省人民医院肿瘤科，贵阳 550002
- 作者简介：
  
  袁　佳，Email：39403621@qq.com，研究方向：妇科肿瘤放化疗、靶向及免疫治疗。
  李利波，Email：llbkinnt@163.com。
- 基金信息：
  
  贵州省卫生健康高质量发展医学科研联合基金资助项目(2025GZYXKYJJXM0128)
- DOI：10.13406/j.cnki.cyxb.004173
  中图分类号： R737.33
- 收稿：2026-07-17，
  
  修回：2026-08-03，
  
  录用：2026-08-06，
  
  纸质出版：2026-10-28
- 稿件说明：
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袁佳，李馨，吴丹妮，等.NLR、PLR与PD-1/CTLA-4抗体联合化疗及贝伐珠单抗一线治疗复发/转移性宫颈癌患者的临床疗效关系分析[J].重庆医科大学学报，2026，51（10）：1441-1451.

Yuan Jia,Li Xin,Wu Danni,et al.Association of neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio with the clinical efficacy of programmed cell death protein-1/cytotoxic T-lymphocyte-associated antigen-4 antibody combined with chemotherapy and bevacizumab as a first-line treatment for patients with recurrent/metastatic cervical cancer[J].Journal of Chongqing Medical University,2026,51(10):1441-1451.
袁佳，李馨，吴丹妮，等.NLR、PLR与PD-1/CTLA-4抗体联合化疗及贝伐珠单抗一线治疗复发/转移性宫颈癌患者的临床疗效关系分析[J].重庆医科大学学报，2026，51（10）：1441-1451. DOI： 10.13406/j.cnki.cyxb.004173.

Yuan Jia,Li Xin,Wu Danni,et al.Association of neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio with the clinical efficacy of programmed cell death protein-1/cytotoxic T-lymphocyte-associated antigen-4 antibody combined with chemotherapy and bevacizumab as a first-line treatment for patients with recurrent/metastatic cervical cancer[J].Journal of Chongqing Medical University,2026,51(10):1441-1451. DOI： 10.13406/j.cnki.cyxb.004173.

摘要

目的

分析治疗前中性粒细胞与淋巴细胞比值（neutrophil-to-lymphocyte ratio，NLR）、血小板与淋巴细胞比值（platelet-to-lymphocyte ratio，PLR）与程序性细胞死亡蛋白-1（programmed cell death protein-1，PD-1）/细胞毒性T淋巴细胞相关抗原4（cytotoxic T-lymphocyte-associated antigen-4，CTLA-4）抗体联合化疗及贝伐珠单抗一线治疗复发/转移性宫颈癌患者的临床疗效关系。

方法

回顾性分析2022年4月至2026年1月于贵州省人民医院肿瘤科接受PD-1/CTLA-4抗体+紫杉醇及铂类+贝伐珠单抗一线治疗的57例复发/转移性宫颈癌患者的临床资料，NLR及PLR的界值分别为2、3、4、5及120、160、200、240，分析治疗前NLR、PLR与无进展生存期（progression-free survival，PFS）、总生存期（overall survival，OS）、客观缓解率（objective response rate，ORR）及疾病控制率（disease control rate，DCR）的关系。

结果

患者中位随访时间13.4个月，ORR和DCR分别为80.7%、91.2%，中位PFS、中位OS未达到。在各界值水平，NLR低的患者PFS及OS均延长，而ORR及DCR降低，但差异均无统计学意义。PLR低的患者OS延长，且PLR

200时OS明显延长（

=0.003）；PLR低的患者PFS呈延长趋势，且ORR更高，但差异无统计学意义。≥3级治疗相关不良事件发生率66.7%，淋巴细胞（52.6%）及白细胞（31.6%）减少最常见；免疫相关不良事件发生率38.6%。

结论

PD-1/CTLA-4抗体+化疗+贝伐珠单抗一线治疗复发/转移性宫颈癌疗效令人鼓舞，治疗前PLR<200与OS延长有明显相关性，但仍需进一步研究。

Abstract

Objective

To investigate the association of neutrophil-to-lymphocyte ratio（NLR） and platelet-to-lymphocyte ratio （PLR） before treatment with the clinical efficacy of programmed cell death protein-1（PD-1）/cytotoxic T-lymphocyte-associated antigen-4（CTLA-4） antibody combined with chemotherapy and bevacizumab as a first-line treatment for patients with recurrent/metastatic cervical cancer.

Methods

A retrospective analysis was performed for the clinical data of 57 patients with recurrent/metastatic cervical cancer who received the first-line treatment of PD-1/CTLA-4 antibody，paclitaxel/platinum-based chemotherapy，and bevacizumab in Department of Oncology，Guizhou Provincial People’s Hospital，from April 2022 to January 2026. The cut-off values of NLR were determined as 2，3，4，and 5，and those for PLR were determined as 120，160，200，and 240. Related methods were used to analyze the association of NLR and PLR before treatment with progression-free survival（PFS），overall survival（OS），objective response rate（ORR），and disease control rate（DCR）.

Results

The median follow-up time was 13.4 months，with an ORR of 80.7% and a DCR of 91.2%，and median PFS and OS were not reached. At the levels of various cut-off values，the patients with low NLR had increases in PFS and OS and reductions in ORR and DCR，with no statistical significance. Compared with the patients with high PLR，the patients with low PLR had a longer OS，especially those with a PLR of

200（

=0.003）；the patients with low PLR tended to have an increase in PFS and a higher ORR，with no statistical significance. The incidence rate of grade≥3 treatment-related adverse events was 66.7%，with the most common adverse reactions of lymphopenia（52.6%） and leukopenia （31.6%），and the incidence rate of immune-related adverse events was 38.6%.

Conclusion

The first-line treatment of PD-1/CTLA-4 antibody combined with chemotherapy and bevacizumab has shown encouraging efficacy in the treatment of recurrent/metastatic cervical cancer，and PLR<200 before treatment is significantly associated with prolonged OS，which requires further research.

关键词

Keywords

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