He Chaobin, Sun Shuxin, Zhang Yu, Li Shengping
Department of Pancreatobiliary Surgery, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, 510060, People's Republic of China.
State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, 510060, People's Republic of China.
J Inflamm Res. 2021 Apr 28;14:1689-1699. doi: 10.2147/JIR.S307884. eCollection 2021.
Irreversible electroporation (IRE) is a novel treatment for locally advanced pancreatic cancer (LAPC), but the predictive factors, based on cytokines and immunocytes of survival, are still lacking. This study aimed to establish a risk model based on cytokines and immunocytes for LAPC patients undergoing IRE treatment.
Peripheral blood samples were obtained from 31 LAPC patients and 8 healthy control subjects before IRE. The phenotypes of lymphocytes were analyzed by flow cytometry, and the cytokines were evaluated with Luminex microarray assay. Least absolute shrinkage and selection operator (LASSO) and Cox regression were applied to assess the prognostic factors for overall survival (OS) and progression-free survival (PFS). A receiver operating characteristic (ROC) curve and a concordance index (C-index) were used to compare the abilities to predict survival rates.
The relationship between multiple cytokines and clinical factors was evaluated and their prognostic value was compared. The five best predictors for OS and PFS, including CA19-9, CD3CD4 T cells, CD3CD8 T cells, IL-17A, and TNF-α were selected and incorporated into a new immune panel. A risk model based on this immune panel was established and exhibited significantly higher values of C-indexes and AUC for OS and PFS prediction as compared with tumor marker score and TNM stage system.
We presented a risk model based on a microarray assay of cytokines and lymphocytes for LAPC patients after receiving IRE treatment for the first time. The established risk model showed relatively good performance in survival prediction and was able to facilitate tailed patient management in clinical practice.
不可逆电穿孔（IRE）是局部晚期胰腺癌（LAPC）的一种新型治疗方法，但基于细胞因子和免疫细胞的生存预测因素仍然缺乏。本研究旨在为接受IRE治疗的LAPC患者建立基于细胞因子和免疫细胞的风险模型。
在IRE治疗前，从31例LAPC患者和8例健康对照者中采集外周血样本。通过流式细胞术分析淋巴细胞表型，并用Luminex微阵列分析法评估细胞因子。应用最小绝对收缩和选择算子（LASSO）及Cox回归评估总生存（OS）和无进展生存（PFS）的预后因素。采用受试者工作特征（ROC）曲线和一致性指数（C指数）比较预测生存率的能力。
评估了多种细胞因子与临床因素之间的关系，并比较了它们的预后价值。选择了OS和PFS的五个最佳预测因子，包括CA19-9、CD3CD4 T细胞、CD3CD8 T细胞、IL-17A和TNF-α，并将其纳入一个新的免疫指标体系。基于该免疫指标体系建立了风险模型，与肿瘤标志物评分和TNM分期系统相比，该模型在OS和PFS预测方面的C指数和AUC值显著更高。
我们首次为接受IRE治疗后的LAPC患者提出了一种基于细胞因子和淋巴细胞微阵列分析的风险模型。所建立的风险模型在生存预测方面表现出相对较好的性能，能够在临床实践中促进有针对性的患者管理。
