Immunotherapy has revolutionized cancer treatment; however, the availability of cost-effective blood-based biomarkers for prognostic and predictive factors of immune treatment in patients with solid tumors remains limited. Due to low cost and easy accessibility, blood-based biomarkers should constitute an essential component of studies to optimize and monitor immunotherapy. Currently available markers that can be measured in peripheral blood include total monocyte count, myeloid-derived suppressor cells (MDSCs), regulatory T cells (Tregs), relative eosinophil count, cytokine levels (such as IL-6, IL-8, and IL-10), lactate dehydrogenase (LDH), C-reactive protein (CRP), soluble forms of CTLA-4 and PD-1 or PD-L1, as well as circulating tumor DNA (ctDNA). In our mini-review, we discuss the latest evidence indicating that routinely accessible peripheral blood parameters—such as the neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), platelet-to-lymphocyte ratio (PLR), and rheological parameters, which so far have been rarely considered for such an application, may be used as non-invasive biomarkers in cancer immunotherapy. Rheological parameters such as whole blood viscosity are influenced by several factors, such as hematocrit, aggregability and deformability of erythrocytes, and plasma viscosity, which is largely dependent on plasma proteins. Especially in cases where the set of symptoms indicates a high probability of hyperviscosity syndrome, blood rheological tests can lead to early diagnosis and treatment. Both biochemical and rheological parameters are prone to become novel and future standards for assessing immunotherapy among patients with solid tumors.
免疫疗法已彻底改变了癌症治疗格局，然而针对实体瘤患者免疫治疗的预后与预测因素，目前仍缺乏具有成本效益的血液生物标志物。基于低成本和高可及性的优势，血液生物标志物应成为优化和监测免疫治疗方案研究体系的核心组成部分。目前可在外周血中检测的标志物包括：单核细胞总数、髓源性抑制细胞（MDSCs）、调节性T细胞（Tregs）、嗜酸性粒细胞相对计数、细胞因子水平（如IL-6、IL-8、IL-10）、乳酸脱氢酶（LDH）、C反应蛋白（CRP）、CTLA-4与PD-1/PD-L1的可溶性形式以及循环肿瘤DNA（ctDNA）。本微型综述探讨的最新证据表明，常规可获取的外周血参数——如中性粒细胞-淋巴细胞比值（NLR）、淋巴细胞-单核细胞比值（LMR）、血小板-淋巴细胞比值（PLR）以及流变学参数（目前在此领域的应用尚属罕见），均有望作为癌症免疫治疗中的无创生物标志物。全血黏度等流变学参数受多种因素影响，包括血细胞比容、红细胞聚集性与变形能力，以及主要取决于血浆蛋白含量的血浆黏度。特别是在临床症状提示高黏滞综合征可能性较高的情况下，血液流变学检测可实现早期诊断与干预。生化参数与流变学参数均有望成为评估实体瘤患者免疫治疗效果的新型未来标准。
肿瘤(癌症)患者之家