Liu Jiang, Hu Guangyin, Zhai Chentong, Wang Jingjing, Xu Wenjing, Xie Jun, Zhu Wugang, Jiang Ping, Liu Degan
Department of Oncology, The Affiliated Xinghua People's Hospital, Medical School of Yangzhou University, Xinghua, Jiangsu 225700, P.R. China.
Oncol Lett. 2023 Apr 3;25(5):198. doi: 10.3892/ol.2023.13784. eCollection 2023 May.
Nutritional indicators have been implicated in the survival outcomes of various malignant tumors. However, there are few studies on the association between nutritional indicators and immunotherapy for esophageal cancer. The present study aimed to explore the value of nutritional indicators with regard to the survival outcomes in patients with metastatic esophageal squamous cell carcinoma (ESCC) treated with camrelizumab. A retrospective cohort analysis of 158 metastatic ESCC patients treated with camrelizumab in The Affiliated Xinghua People's Hospital, Medical School of Yangzhou University (Xinghua, China) between September 2019 and July 2022 was conducted. A receiver operating characteristic curve was used to determine the optimal cut-off values of prognostic nutritional index (PNI) and albumin (ALB). The cut-off value for body mass index (BMI) was set at the normal lower limit (18.5 kg/m). Progression-free survival (PFS) and overall survival (OS) were evaluated using the Kaplan-Meier method, and the differences in PFS or OS between groups were compared using the log-rank test. The prognostic value of each variable was analyzed based on the univariate and multivariate Cox proportional hazards regression models. The optimal cutoff values of PNI, ALB and BMI were 41.35, 36.8 g/l and 18.5 kg/m, respectively. Lower PNI, ALB and BMI were closely associated with shorter PFS [hazard ratio (HR) for PNI, 3.599; P<0.001; HR for ALB, 4.148; P<0.001; HR for BMI, 5.623; P<0.001) and OS (HR for PNI, 7.605; P<0.001; HR for ALB, 7.852; P<0.001; HR for BMI, 7.915; P<0.001) times. Univariate and multivariate Cox regression analyses indicated that lower PNI, ALB and BMI were independent risk factors of PFS and OS in patients with metastatic ESCC receiving camrelizumab treatment. In conclusion, PNI, ALB and BMI are promising predictive indicators to assess the survival outcomes in patients with metastatic ESCC treated with camrelizumab. Moreover, PNI, ALB and BMI may have prognostic significance in these patients.
营养指标与多种恶性肿瘤的生存结果有关。然而，关于营养指标与食管癌免疫治疗之间关联的研究较少。本研究旨在探讨营养指标对接受卡瑞利珠单抗治疗的转移性食管鳞状细胞癌（ESCC）患者生存结果的价值。对2019年9月至2022年7月期间在扬州大学医学院附属兴化人民医院（中国兴化）接受卡瑞利珠单抗治疗的158例转移性ESCC患者进行了回顾性队列分析。采用受试者工作特征曲线确定预后营养指数（PNI）和白蛋白（ALB）的最佳临界值。体重指数（BMI）的临界值设定为正常下限（18.5kg/m²）。采用Kaplan-Meier法评估无进展生存期（PFS）和总生存期（OS），并使用对数秩检验比较各组之间PFS或OS的差异。基于单因素和多因素Cox比例风险回归模型分析每个变量的预后价值。PNI、ALB和BMI的最佳临界值分别为41.35、36.8g/L和18.5kg/m²。较低的PNI、ALB和BMI与较短的PFS[PNI的风险比（HR）为3.599；P<0.001；ALB的HR为4.148；P<0.001；BMI的HR为5.623；P<0.001]和OS（PNI的HR为7.605；P<0.001；ALB的HR为7.852；P<0.001；BMI的HR为7.915；P<0.001）密切相关。单因素和多因素Cox回归分析表明，较低的PNI、ALB和BMI是接受卡瑞利珠单抗治疗的转移性ESCC患者PFS和OS的独立危险因素。总之，PNI、ALB和BMI是评估接受卡瑞利珠单抗治疗的转移性ESCC患者生存结果的有前景的预测指标。此外，PNI、ALB和BMI在这些患者中可能具有预后意义。
