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外周血炎性指标在晚期胃癌免疫检查点抑制剂治疗效果及预后价值中的临床研究

张俏 周学志 程赛 孟涛 高正杰 张德重 朱绍辉

张俏, 周学志, 程赛, 孟涛, 高正杰, 张德重, 朱绍辉. 外周血炎性指标在晚期胃癌免疫检查点抑制剂治疗效果及预后价值中的临床研究[J]. 中华全科医学, 2024, 22(2): 198-201. doi: 10.16766/j.cnki.issn.1674-4152.003364
引用本文: 张俏, 周学志, 程赛, 孟涛, 高正杰, 张德重, 朱绍辉. 外周血炎性指标在晚期胃癌免疫检查点抑制剂治疗效果及预后价值中的临床研究[J]. 中华全科医学, 2024, 22(2): 198-201. doi: 10.16766/j.cnki.issn.1674-4152.003364
ZHANG Qiao, ZHOU Xuezhi, CHENG Sai, MENG Tao, GAO Zhengjie, ZHANG Dezhong, ZHU Shaohui. Clinical study on the therapeutic effect and prognostic value of peripheral blood inflammatory indexes in the treatment of advanced gastric cancer with immune checkpoint inhibitors[J]. Chinese Journal of General Practice, 2024, 22(2): 198-201. doi: 10.16766/j.cnki.issn.1674-4152.003364
Citation: ZHANG Qiao, ZHOU Xuezhi, CHENG Sai, MENG Tao, GAO Zhengjie, ZHANG Dezhong, ZHU Shaohui. Clinical study on the therapeutic effect and prognostic value of peripheral blood inflammatory indexes in the treatment of advanced gastric cancer with immune checkpoint inhibitors[J]. Chinese Journal of General Practice, 2024, 22(2): 198-201. doi: 10.16766/j.cnki.issn.1674-4152.003364

外周血炎性指标在晚期胃癌免疫检查点抑制剂治疗效果及预后价值中的临床研究

doi: 10.16766/j.cnki.issn.1674-4152.003364
基金项目: 

国家自然科学基金项目 82302298

河南省医学科技攻关计划联合共建项目 LHGJ20210523

河南省医学科技攻关计划联合共建项目 LHGJ20220597

河南省医学科技攻关计划项目 19A320003

详细信息
    通讯作者:

    朱绍辉,E-mail:shaohui912@126.com

  • 中图分类号: R735.2 R730.43

Clinical study on the therapeutic effect and prognostic value of peripheral blood inflammatory indexes in the treatment of advanced gastric cancer with immune checkpoint inhibitors

  • 摘要:   目的  探究预后营养指数(PNI)、中性粒细胞与淋巴细胞比值(NLR)、血小板与淋巴细胞比值(PLR)对接受免疫检查点抑制剂(ICIs)治疗的晚期胃癌(AGC)疗效及预后价值评估。  方法  回顾性分析新乡医学院第一附属医院2019年6月—2022年1月接受ICIs治疗75例AGC患者的临床资料。应用ROC曲线计算PNI、NLR、PLR最佳截断值。绘制Kaplan-Meier曲线并运用Cox比例风险模型预测影响AGC总生存期(OS)的独立危险因素。  结果  PNI、NLR0、PLR0、PLR4的最佳截断值为36.00、3.45、186.65、138.23。高PNI组和低PLR0组客观缓解率(ORR)更高;高PNI组、低NLR0组、低PLR0组和低PLR4组疾病控制率(DCR)更高,差异均有统计学意义(P<0.05)。单因素分析显示,PNI、NLR0、PLR0、PLR4、BMI、分期均与OS相关。多因素分析显示,分期(HR=2.040,95% CI:1.120~3.730,P=0.020)及PLR0(HR=3.539,95% CI:1.717~7.296,P<0.001)是OS的独立影响因素。  结论  PNI、NLR0、PLR0、PLR4对接受ICIs治疗的AGC疗效及预后具有临床指导价值。

     

  • 图  1  接受ICIs治疗的AGC患者生存曲线

    Figure  1.  Survival curves of AGC patients treated with ICIs

    表  1  不同水平PNI、NLR0、PLR0及PLR4的AGC患者治疗后ORR和DCR比较[例(%)]

    Table  1.   Comparison of ORR and DCR after treatment in AGC patients with different levels of PNI, NLR0, PLR0 and PLR4 [cases (%)]

    组别 例数 ORR DCR
    低PNI组(PNI≤36.00) 22 1(4.76) 5(22.73)
    高PNI组(PNI>36.00) 53 15(28.30) 49(92.45)
    χ2 3.908 37.491
    P 0.048 <0.001
    低NLR0组(NLR≤3.45) 49 13(26.53) 45(91.84)
    高NLR0组(NLR>3.45) 26 3(11.54) 9(34.62)
    χ2 2.275 27.589
    P 0.131 <0.001
    低PLR0组(PLR≤186.65) 49 15(30.61) 44(89.79)
    高PLR0组(PLR>186.65) 26 1(3.85) 9(34.62)
    χ2 7.252 24.952
    P 0.007 <0.001
    低PLR4组(PLR≤138.23) 53 13(24.53) 48(90.56)
    高PLR4组(PLR>138.23) 22 3(13.64) 6(27.27)
    χ2 0.546 30.893
    P 0.460 <0.001
    下载: 导出CSV

    表  2  影响晚期胃癌患者OS的单因素和多因素分析

    Table  2.   Univariate and multivariate analysis of OS in patients with advanced gastric cancer

    变量 单因素分析 多因素分析
    HR 95% CI P HR 95% CI P
    高PNI(参照:低PNI) 0.424 0.253~0.711 <0.001 0.537 0.276~1.044 0.067
    高NLR0(参照:低NLR0) 1.710 1.050~2.780 0.020 0.727 0.349~1.511 0.393
    高PLR0(参照:低PLR0) 5.702 3.299~9.855 <0.001 3.539 1.717~7.296 <0.001
    高PLR4(参照:低PLR4) 2.087 1.258~3.463 0.002 1.457 0.735~2.888 0.280
    高BMI(参照:低BMI) 0.485 0.302~0.780 0.003 0.910 0.510~1.630 0.750
    分期Ⅳ期(参照:Ⅲ期) 2.296 1.360~3.876 0.002 2.040 1.120~3.730 0.020
    下载: 导出CSV
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  • 收稿日期:  2023-08-12
  • 网络出版日期:  2024-03-27

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