肺免疫预后指数在食管鳞状细胞癌切除患者中的预后意义
Prognostic Significance of the Lung Immune Prognostic Index in Patients with Resected Esophageal Squamous Cell Carcinoma.
作者信息
Feng Ji-Feng, Zhao Jian-Ming, Chen Sheng, Chen Qi-Xun
机构信息
Department of Thoracic Oncological Surgery, Institute of Cancer Research and Basic Medical Sciences of Chinese Academy of Sciences, Cancer Hospital of University of Chinese Academy of Sciences, Zhejiang Cancer Hospital, Hangzhou, 310022, People's Republic of China.
Key Laboratory Diagnosis and Treatment Technology on Thoracic Oncology, Hangzhou, 310022, People's Republic of China.
出版信息
Cancer Manag Res. 2021 Mar 26;13:2811-2819. doi: 10.2147/CMAR.S298412. eCollection 2021.
BACKGROUND
The lung immune prognostic index (LIPI), a novel index combined with serum lactate dehydrogenase (LDH) and derived neutrophil to lymphocyte ratio (dNLR), is recently proposed to predict prognosis in lung cancer. The LIPI is not a unique indicator for lung cancer. However, the prognostic role of LIPI has not yet been evaluated in extra-pulmonary cancer. The aim of this study was to determine whether LIPI is still a useful prognostic indicator for patients with resected esophageal squamous cell carcinoma (ESCC).
METHODS
The clinical data including preoperative laboratory results for 361 consecutive resected ESCC cases from 2007 to 2010 were retrospectively analyzed. A LIPI based on serum LDH and dNLR was conducted, characterizing into 3 groups (LIPI 0, 1 and 2). The association between LIPI and cancer-specific survival (CSS) was analyzed according to the Kaplan-Meier method and Cox regression analysis with hazard ratio (HR) and 95% confidence interval (CI). A nomogram model was conducted by R 3.6.0 software.
RESULTS
In this study, 220 (60.9%), 100 (27.7%) and 41 (11.4%) patients had a LIPI of 0, 1 and 2, respectively. The 5-year CSS for LIPI 0, 1 and 2 was 40.9%, 19.0% and 9.8%, respectively (<0.001). Subgroup analysis based on TNM stage revealed that HALP was also significantly related to CSS in any stage (TNM I: =0.002; TNM II: =0.009; TNM III: =0.031). The LIPI serves as an independent predictor regarding CSS in multivariate analyses in patients with resected ESCC. Compared to LIPI 0, LIPI 1 and 2 had an HR of 1.419 (95% CI: 1.063-1.895, =0.018) and 2.064 (95% CI: 1.403-3.036, <0.001) regarding CSS, respectively. A nomogram was also developed in individualized CSS prediction based on LIPI in patients with resected ESCC.
CONCLUSION
To the best of our knowledge, the present study is the first study to explore the association between LIPI and prognosis in patients with extra-pulmonary cancer. The LIPI, combined with LDH and dNLR, is still a potential independent prognostic marker in patients with resected ESCC.
背景
肺免疫预后指数（LIPI）是一种结合血清乳酸脱氢酶（LDH）和衍生中性粒细胞与淋巴细胞比值（dNLR）的新型指数，最近被提出用于预测肺癌预后。LIPI并非肺癌的唯一指标。然而，LIPI在肺外癌症中的预后作用尚未得到评估。本研究的目的是确定LIPI对接受手术切除的食管鳞状细胞癌（ESCC）患者是否仍是一个有用的预后指标。
方法
回顾性分析2007年至2010年连续361例接受手术切除的ESCC患者的临床资料，包括术前实验室检查结果。基于血清LDH和dNLR计算LIPI，并分为3组（LIPI 0、1和2）。根据Kaplan-Meier法和Cox回归分析，采用风险比（HR）和95%置信区间（CI）分析LIPI与癌症特异性生存（CSS）之间的关联。使用R 3.6.0软件构建列线图模型。
结果
在本研究中，LIPI为0、1和2的患者分别有220例（60.9%）、100例（27.7%）和41例（11.4%）。LIPI为0、1和2的患者5年CSS分别为40.9%、19.0%和9.8%（<0.001）。基于TNM分期的亚组分析显示，在任何分期（TNM I：=0.002；TNM II：=0.009；TNM III：=0.031）中，LIPI也与CSS显著相关。在接受手术切除的ESCC患者的多因素分析中，LIPI是CSS的独立预测指标。与LIPI 0相比，LIPI 1和2关于CSS的HR分别为1.419（95%CI：1.063 - 1.895，=0.018）和2.064（95%CI：1.403 - 3.036，<0.001）。还基于LIPI构建了用于接受手术切除的ESCC患者个体CSS预测的列线图。
结论
据我们所知，本研究是首次探讨LIPI与肺外癌症患者预后之间关联的研究。结合LDH和dNLR的LIPI仍是接受手术切除的ESCC患者潜在的独立预后标志物。
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