预后营养指数作为免疫检查点抑制剂治疗胃肠道癌症患者的预后生物标志物。

Prognostic nutritional index as a prognostic biomarker for gastrointestinal cancer patients treated with immune checkpoint inhibitors.

机构信息

Department of General Surgery, Renmin Hospital of Wuhan University, Wuhan, China.

Key Laboratory of Hubei Province for Digestive System Disease, Wuhan, China.

出版信息

Front Immunol. 2023 Jul 21;14:1219929. doi: 10.3389/fimmu.2023.1219929. eCollection 2023.

OBJECTIVE

Our study represents the first meta-analysis conducted to evaluate the prognostic utility of the baseline prognostic nutritional index (PNI) in patients with gastrointestinal cancer (GIC) who received immune checkpoint inhibitor (ICI) therapy.

METHODS

We searched PubMed, the Cochrane Library, EMBASE, and Google Scholar until April 23, 2023, to obtain relevant articles for this study. Our analysis examined several clinical outcomes, including overall survival (OS), progression-free survival (PFS), objective response rate (ORR), and disease control rate (DCR).

RESULTS

In this analysis, a total of 17 articles with 2883 patients were included. Our pooled results indicated that patients with high PNI levels had longer OS (HR: 0.530, 95% CI: 0.456-0.616, < 0.001) and PFS (HR: 0.740, 95% CI: 0.649-0.844, < 0.001), as well as higher ORR (OR: 1.622, 95% CI: 1.251-2.103, < 0.004) and DCR (OR: 1.846, 95% CI: 1.428-2.388, < 0.001). Subgroup analysis showed that PNI cutoff values of 40 to 45 showed greater predictive potential. Subgroup analysis also confirmed that the above findings still hold true in patients with esophageal cancer, gastric cancer, and hepatocellular carcinomas.

CONCLUSION

The PNI were reliable predictors of outcomes in GIC patients treated with ICIs.

目的

本研究代表了首次进行的荟萃分析，旨在评估基线预后营养指数（PNI）在接受免疫检查点抑制剂（ICI）治疗的胃肠道癌症（GIC）患者中的预后预测价值。

方法

我们检索了 PubMed、Cochrane 图书馆、EMBASE 和 Google Scholar，截至 2023 年 4 月 23 日，以获取本研究相关的文章。我们的分析检查了几个临床结局，包括总生存期（OS）、无进展生存期（PFS）、客观缓解率（ORR）和疾病控制率（DCR）。

结果

在这项分析中，共纳入了 17 篇包含 2883 名患者的文章。我们的汇总结果表明，PNI 水平较高的患者具有更长的 OS（HR：0.530，95%CI：0.456-0.616，<0.001）和 PFS（HR：0.740，95%CI：0.649-0.844，<0.001），以及更高的 ORR（OR：1.622，95%CI：1.251-2.103，<0.004）和 DCR（OR：1.846，95%CI：1.428-2.388，<0.001）。亚组分析表明，PNI 截断值为 40 至 45 时具有更大的预测潜力。亚组分析还证实，上述发现对于食管癌、胃癌和肝细胞癌患者仍然成立。