基于三分类风险评估量表的 Gustave Roussy 免疫评分可作为手术可切除的早期非小细胞肺癌的新型有效预后指标：一项倾向评分匹配回顾性队列研究。
Gustave Roussy Immune Score based on a three-category risk assessment scale serves as a novel and effective prognostic indicator for surgically resectable early-stage non-small-cell lung cancer: A propensity score matching retrospective cohort study.
机构信息
Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, 610041, China; Division of General Thoracic Surgery, Inselspital, Bern University Hospital, University of Bern, CH-3010, Bern, Switzerland.
Division of General Thoracic Surgery, Inselspital, Bern University Hospital, University of Bern, CH-3010, Bern, Switzerland.
出版信息
Int J Surg. 2020 Dec;84:25-40. doi: 10.1016/j.ijsu.2020.10.015. Epub 2020 Oct 18.
BACKGROUNDS
The Gustave Roussy Immune score (GRIm-Score) emerges as a novel prognostic scoring system for patient selection in phase I trials testing targeted immunotherapy for advanced-stage cancer. We tried to assess potential prognostic roles of preoperative GRIm-Score in patients undergoing video-assisted thoracoscopic surgery (VATS) lobectomy for stage I-II non-small-cell lung cancer (NSCLC) by propensity score-matching (PSM) analysis.
METHODS
This PSM-based analysis was performed on our single-center prospectively-maintained database between January 2014 and October 2015. A Kaplan-Meier survival analysis using the log-rank test was used to distinguish differences in both overall survival (OS) and disease-free survival (DFS) between the patients stratified by preoperative GRIm-Score. Multivariable Cox-proportional hazards regression analysis and PSM analysis were both carried out to determine the final independent prognostic parameters.
RESULTS
There were 405 patients with surgically resectable stage I-II NSCLC included. Both OS and DFS were significantly shortened along with each number increase in the GRIm-Score group, showing a step-wise fashion. Such strong correlations between preoperative GRIm-Score estimated by a modified 3-category risk scale and survival outcomes still remained validated after PSM analysis. In addition, this GRIm-Score held the superior discriminatory power for predicting both OS and DFS to the other peripheral blood biomarkers. Multivariable analyses on the entire cohort and the PSM cohort demonstrated that GRIm-Score based on a 3-category risk assessment scale could be independently predictive of both OS and DFS.
CONCLUSIONS
The GRIm-Score tool can also serve as an effective and noninvasive marker to optimize prognostic prediction for surgically resectable stage I-II NSCLC.
背景
Gustave Roussy 免疫评分（GRIm-Score）是一种新的预后评分系统，用于选择接受靶向免疫治疗晚期癌症的 I 期试验患者。我们试图通过倾向评分匹配（PSM）分析评估术前 GRIm-Score 在接受电视辅助胸腔镜手术（VATS）肺叶切除术的 I-II 期非小细胞肺癌（NSCLC）患者中的潜在预后作用。
方法
这项基于 PSM 的分析是在我们的单中心前瞻性维护数据库中进行的，时间范围为 2014 年 1 月至 2015 年 10 月。使用对数秩检验的 Kaplan-Meier 生存分析用于区分术前 GRIm-Score 分层患者的总生存（OS）和无病生存（DFS）之间的差异。进行多变量 Cox 比例风险回归分析和 PSM 分析，以确定最终的独立预后参数。
结果
共有 405 例可手术切除的 I-II 期 NSCLC 患者纳入研究。随着 GRIm-Score 组中数字的增加，OS 和 DFS 均显著缩短，呈阶梯式。在经过 PSM 分析后，术前 GRIm-Score 经修正的 3 级风险评分与生存结果之间的这种强相关性仍然得到验证。此外，该 GRIm-Score 在预测 OS 和 DFS 方面优于其他外周血生物标志物。对整个队列和 PSM 队列的多变量分析表明，基于 3 级风险评估的 GRIm-Score 可独立预测 OS 和 DFS。
结论
GRIm-Score 工具也可以作为一种有效且无创的标志物，优化对可手术切除的 I-II 期 NSCLC 的预后预测。
Zotero 插件