碱性磷酸酶联合γ-谷氨酰转移酶是接受程序性死亡受体-1 抑制剂治疗的肝细胞癌患者预后的独立预测因子。

Alkaline phosphatase combined with γ-glutamyl transferase is an independent predictor of prognosis of hepatocellular carcinoma patients receiving programmed death-1 inhibitors.

机构信息

Hepatic Surgery Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.

Department of Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.

出版信息

Front Immunol. 2023 Jan 25;14:1115706. doi: 10.3389/fimmu.2023.1115706. eCollection 2023.

DOI:10.3389/fimmu.2023.1115706

PMID:36761721

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9905229/

Abstract

BACKGROUND

Immunotherapy plays an increasingly critical role in the systemic treatment of HCC. This current study aimed to establish a novel prognostic predictor of Programmed death 1 (PD-1) inhibitor therapy in hepatocellular carcinoma (HCC) independent of Child-Pugh grade.

METHODS

Our study screened patients with HCC who received PD-1 inhibitors at Tongji Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology from January 2018 to December 2020. ALG grade was determined by the patient's serum ALP and GGT levels before the initiation of PD-1 inhibitors. The endpoints of our study were overall survival (OS) and progression free survival (PFS). Follow-up ended at May 31, 2022.

RESULTS

Eighty- five patients (77 with Child-Pugh grade A, 8 with Child-Pugh grade B at baseline) were enrolled according to the inclusion criteria. Patients with Child-Pugh grade A achieved longer PFS and OS than those with Child-Pugh grade B. Patients with ALG grade 3 at baseline showed worse tumor response and poorer survival, and ALG grade could stratify patients with Child-Pugh grade A into subgroups with significantly different prognosis.

CONCLUSIONS

ALG grade, combining ALP and GGT, is a novel and readily available prognostic marker and the predictive effect of ALG grade on patient prognosis is independent of Child-Pugh grade.

摘要

背景

免疫疗法在肝癌的系统治疗中发挥着越来越重要的作用。本研究旨在建立一种新的预测标志物，用于预测 PD-1 抑制剂治疗肝细胞癌（HCC）的疗效，该标志物独立于 Child-Pugh 分级。

方法

我们的研究筛选了 2018 年 1 月至 2020 年 12 月期间在华中科技大学同济医学院附属同济医院接受 PD-1 抑制剂治疗的 HCC 患者。ALG 分级是根据患者开始使用 PD-1 抑制剂前的血清 ALP 和 GGT 水平来确定的。本研究的终点是总生存期（OS）和无进展生存期（PFS）。随访截止日期为 2022 年 5 月 31 日。

结果

根据纳入标准，共纳入 85 例患者（77 例基线时为 Child-Pugh 分级 A，8 例基线时为 Child-Pugh 分级 B）。Child-Pugh 分级 A 的患者的 PFS 和 OS 均长于 Child-Pugh 分级 B 的患者。基线时 ALG 分级为 3 级的患者肿瘤反应较差，生存较差，ALG 分级可将 Child-Pugh 分级 A 的患者分为具有显著不同预后的亚组。