术前血小板-淋巴细胞比值（PLR）作为亚洲 HIV 感染胃癌患者的预后炎症生物标志物：一项单中心研究。
Preoperative Platelet-Lymphocyte Ratio (PLR) as a prognostic inflammation biomarker in Asian HIV-infected patients with gastric cancer: a single-center study.
机构信息
Department of General Surgery, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China.
Department of Infectious Diseases, Children's Hospital of Fudan University, Shanghai, China.
出版信息
BMC Gastroenterol. 2023 May 26;23(1):187. doi: 10.1186/s12876-023-02828-x.
BACKGROUND
The serum systemic inflammation biomarkers have been established as predictors of prognosis in gastric cancer (GC) patients, but their prognostic value in human immunodeficiency virus (HIV)-infected patients with GC has not been well studied. This retrospective study aimed to evaluate the prognostic value of preoperative systemic inflammation biomarkers in Asian HIV-infected patients with GC.
METHODS
We retrospectively analyzed 41 HIV-infected GC patients who underwent surgery between January 2015 and December 2021 at the Shanghai Public Health Clinical Center. Preoperative systemic inflammation biomarkers were measured and patients were divided into two groups based on the optimal cut-off value. Overall survival (OS) and progression-free survival (PFS) were measured using the Kaplan-Meier method and the log-rank test. Multivariate analysis of variables was performed using the Cox proportional regression model. As a comparison, 127 GC patients without HIV infection were also recruited.
RESULTS
The median age of the 41 patients included in the study was 59 years, with 39 males and two females. The follow-up period for OS and PFS ranged from 3 to 94 months. The cumulative three-year OS rate was 46.0%, and the cumulative three-year PFS rate was 44%. HIV-infected GC patients had worse clinical outcomes compared to the normal GC population. The optimal cut-off value for preoperative platelet to lymphocyte ratio (PLR) was 199 in HIV-infected GC patients. Multivariate Cox regression analysis revealed that a low PLR was an independent predictor of better OS and PFS (OS: HR = 0.038, 95% CI: 0.006-0.258, P < 0.001; PFS: HR = 0.027, 95% CI: 0.004-0.201, P < 0.001). Furthermore, higher preoperative PLR in HIV-infected GC was significantly associated with lower BMI, hemoglobin, albumin, CD4 + T, CD8 + T, and CD3 + T cell counts.
CONCLUSION
The preoperative PLR is an easily measurable immune biomarker that may provide useful prognostic information in HIV-infected GC patients. Our findings suggest that PLR could be a valuable clinical tool for guiding treatment decisions in this population.
背景
血清系统性炎症生物标志物已被确立为预测胃癌（GC）患者预后的指标，但它们在 HIV 感染合并 GC 患者中的预后价值尚未得到充分研究。本回顾性研究旨在评估术前系统性炎症生物标志物在亚洲 HIV 感染合并 GC 患者中的预后价值。
方法
我们回顾性分析了 2015 年 1 月至 2021 年 12 月在上海市公共卫生临床中心接受手术治疗的 41 例 HIV 感染合并 GC 患者。测量了术前系统性炎症生物标志物，并根据最佳截断值将患者分为两组。使用 Kaplan-Meier 法和对数秩检验测量总生存期（OS）和无进展生存期（PFS）。使用 Cox 比例风险回归模型对变量进行多变量分析。作为比较，还招募了 127 例无 HIV 感染的 GC 患者。
结果
研究纳入的 41 例患者的中位年龄为 59 岁，男性 39 例，女性 2 例。OS 和 PFS 的随访时间为 3 至 94 个月。累积三年 OS 率为 46.0%，累积三年 PFS 率为 44%。与正常 GC 人群相比，HIV 感染合并 GC 患者的临床结局较差。HIV 感染合并 GC 患者术前血小板与淋巴细胞比值（PLR）的最佳截断值为 199。多变量 Cox 回归分析显示，低 PLR 是 OS 和 PFS 更好的独立预测因素（OS：HR=0.038，95%CI：0.006-0.258，P<0.001；PFS：HR=0.027，95%CI：0.004-0.201，P<0.001）。此外，HIV 感染合并 GC 患者术前较高的 PLR 与较低的 BMI、血红蛋白、白蛋白、CD4+T、CD8+T 和 CD3+T 细胞计数显著相关。
结论
术前 PLR 是一种易于测量的免疫生物标志物，可为 HIV 感染合并 GC 患者提供有用的预后信息。我们的研究结果表明，PLR 可能是指导该人群治疗决策的有价值的临床工具。
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