Department of Medicine and Biosystemic Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.
Department of Medical Oncology, Clinical Research Institute, National Hospital Organization Kyushu Medical Center, 1-8-1, Jigyouhama, Chuou-ku, Fukuoka, 810-0065, Japan.
Sci Rep. 2021 Feb 2;11(1):2741. doi: 10.1038/s41598-021-82448-1.
Although the neutrophil to lymphocyte ratio (NLR) was reported to be a predictive biomarker for clinical outcomes in various types of cancer, including recurrent or metastatic head and neck cancer (R/M HNSCC) treated with nivolumab, the usefulness of the pretreatment C-reactive protein/albumin ratio (CAR) as a prognostic marker remains to be clarified. This study aimed to analyze the clinical usability of the CAR in comparison with that of the NLR. 46 R/M HNSCC patients treated with nivolumab were retrospectively analyzed. The optimal cutoff value for the CAR was calculated using receiver operating characteristic curve analysis. The optimal cutoff value for the CAR was set to 0.30. On multivariate analyses, a high CAR was significantly associated with poor overall survival (adjusted HR, 2.19; 95% CI, 1.42-3.47; p < 0.01) and progression-free survival (adjusted HR, 1.98; 95% CI, 1.38-2.80; p < 0.01). The overall response rate and disease control rate for the high CAR patients were lower than for the low CAR patients. The CAR had significantly higher area under the curve values than the NLR at 2 and 4 months. The pretreatment CAR might be an independent marker for prognosis and efficacy in R/M HNSCC patients treated with nivolumab.
虽然中性粒细胞与淋巴细胞比值（NLR）已被报道为包括复发性或转移性头颈部癌症（R/M HNSCC）在内的多种癌症的临床结局的预测生物标志物，但其在接受nivolumab 治疗的 R/M HNSCC 患者中的预后价值仍有待明确。本研究旨在分析 C 反应蛋白/白蛋白比值（CAR）与 NLR 相比的临床可用性。回顾性分析了 46 例接受 nivolumab 治疗的 R/M HNSCC 患者。采用受试者工作特征曲线分析计算 CAR 的最佳截断值。CAR 的最佳截断值设定为 0.30。多因素分析显示，高 CAR 与总生存期（调整 HR，2.19；95%CI，1.42-3.47；p<0.01）和无进展生存期（调整 HR，1.98；95%CI，1.38-2.80；p<0.01）显著相关。高 CAR 患者的总体缓解率和疾病控制率低于低 CAR 患者。在 2 个月和 4 个月时，CAR 的曲线下面积值均显著高于 NLR。CAR 可能是接受 nivolumab 治疗的 R/M HNSCC 患者预后和疗效的独立标志物。
