晚期肾上腺皮质癌（ACC）的治疗包括单独使用米托他酚或联合埃托泊赛、多柔比星和顺铂（EDP）。虽然这两种治疗方法被广泛使用，但仍缺乏反应标志物。鉴于炎症基础评分已被提出作为ACC的预后因素，我们旨在研究它们在预测一线化疗反应中的作用。我们对接受米托他酚单药疗法或EDP±米托他酚治疗的晚期ACC患者进行了回顾性分析。研究了临床参数（诊断时的肿瘤分期、切除情况、Ki67、诊断至治疗开始的时间、表现状态、血浆米托他水平、达到米托他目标时间≥80%、临床表现的皮质醇高分泌）和预处理的炎症基础评分（中性粒细胞与淋巴细胞比率（NLR）、血小板与淋巴细胞比率（PLR）、单核细胞与淋巴细胞比率（MLR）、派生中性粒细胞与淋巴细胞比率（dNLR））。主要终点是治疗开始后的总生存期（OS）和时间进展（TTP），次要终点是治疗的最佳客观反应。纳入了90名患者（59％为女性，中位年龄为51岁），其中40名接受米托他酚单药治疗，50名接受EDP±米托他酚治疗。在米托他酚单药治疗组中，NLR≥5和PLR≥190预示着较短的OS（HR：145.83，95％CI：1.87-11323.83；HR：165.50，95％CI：1.76-15538.04），在包括临床变量的多变量分析中仍显著。NLR也与较短的TTP有关（HR：2.58，95％CI：1.28-5.20），但仅在单因素分析中有关联。NLR≥5的患者比NLR<5的患者治疗反应更差（p=0.040）。在EDP±米托他酚治疗组中，NLR≥5在单因素分析中预示着较短的OS（HR：2.52，95％CI：1.30-4.88）和TTP（HR：1.95，95％CI：1.04-3.66）。总之，从常规测量的参数计算出的炎症基础评分可能有助于预测晚期ACC的化疗反应。

Treatment for advanced adrenocortical carcinoma (ACC) consists of mitotane alone or combined with etoposide, doxorubicin and cisplatin (EDP). Although both therapies are widely used, markers of response are still lacking. Since inflammation-based scores have been proposed as prognostic factors in ACC, we aimed to investigate their role in predicting the response to first-line chemotherapy. We performed aretrospective analysis of patients with advanced ACC treated with mitotane monotherapy or EDP±mitotane. Clinical parameters (tumour stage at diagnosis, resection status, Ki67, time from diagnosis to treatment start, performance status, plasma mitotane levels, time in mitotane target ≥80%, clinically overt cortisol hypersecretion) and pretreatment inflammation-based scores [neutrophil-to-lymphocyte-ratio (NLR), platelet-to-lymphocyte-ratio (PLR), monocyte-to-lymphocyte-ratio (MLR), derived neutrophil-to-lymphocyte ratio (dNLR)] were investigated. The primary endpoints were overall survival (OS) and time-to-progression (TTP) from treatment initiation, the secondary endpoint was the best objective response to treatment. We included 90 patients (59%=women, median age=51 years) treated with mitotane monotherapy (n=40) or EDP±mitotane (n=50). In the mitotane monotherapy cohort, NLR≥5 and PLR≥190 predicted shorter OS (HR: 145.83, 95%CI: 1.87-11323.83; HR: 165.50, 95%CI: 1.76-15538.04, respectively), remaining significant at multivariable analysis including clinical variables. NLR was also associated with shorter TTP (HR: 2.58, 95%CI: 1.28-5.20), but only at univariable analysis. Patients with NLR≥5 showed a worse treatment response than those with NLR<5 (p=0.040). In the EDP±mitotane cohort, NLR≥5 predicted shorter OS (HR: 2.52, 95%CI: 1.30-4.88) and TTP (HR: 1.95, 95%CI: 1.04-3.66) at univariable analysis. In conclusion,inflammation-based scores, calculated from routinely measured parameters, may help predict response to chemotherapy in advanced ACC.