血红蛋白、白蛋白、淋巴细胞和血小板评分（HALP）和改良 Gustave Roussy 免疫评分对接受同步放化疗的食管鳞状细胞癌患者的预测价值。
Predictive values of the hemoglobin, albumin, lymphocyte and platelet score (HALP) and the modified -Gustave Roussy immune score for esophageal squamous cell carcinoma patients undergoing concurrent chemoradiotherapy.
机构信息
Department of Oncology, Jurong Hospital Affiliated to Jiangsu University, Zhenjiang, Jiangsu, China.
Department of Radiotherapy Oncology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China.
出版信息
Int Immunopharmacol. 2023 Oct;123:110773. doi: 10.1016/j.intimp.2023.110773. Epub 2023 Aug 8.
UNLABELLED
The hemoglobin, albumin, lymphocyte and platelet (HALP) score and the Gustave Roussy immune score (GRIm⁃Score) are prognostic markers in several types of malignant tumors. The prognostic values of HALP score and GRIm⁃Score in concurrent chemoradiotherapy for unresectable esophageal cancer remain unknown.
METHODS
We enrolled 150 esophageal squamous cell carcinoma (ESCC) patients who underwent concurrent chemoradiotherapy in our institution between 2013 and 2018. The cutoff values for HALP, and GRIm⁃Score were defined by using receiver's operating characteristic curves. Survival was analyzed with the Kaplan- Meier method, with differences analyzed with the log-rank test. Multivariate Cox proportional-hazards models were used to evaluate the prognostic significance of HALP and GRIm for ESCC.
RESULTS
HALP was significantly associated with the Zubrod ECOG WHO performance status, tumor location, and the clinical tumor, node, metastasis stage. Modified GRIm (mGRIm) was only significantly associated with metastasis / recurrence before radiotherapy (χ = 6.25). Univariate Cox regression analysis showed that higher mGRIm (HR 1.9 95%CI 1.3-2.9) and lower HALP (HR 2.4 95%CI 1.6-3.7) were all associated with worse OS. Multivariate COX analysis found that higher mGRIm score (HR 1.7 95%CI 1.1-2.6), and lower HALP score (HR 2 95%CI 1.3-3.2) were both independent risk factors of overall survival. The nomogram c-index in inside validation was 0.66.
CONCLUSION
Both HALP and mGRIm are independent prognostic factors for patients with unresectable ESCC.
目的
血红蛋白（Hb）、白蛋白（Alb）、淋巴细胞（Lym）和血小板（Plt）评分（HALP）和 Gustave Roussy 免疫评分（GRIm⁃Score）是多种恶性肿瘤的预后标志物。HALP 评分和 GRIm⁃Score 在不可切除食管癌同步放化疗中的预后价值尚不清楚。
方法
我们纳入了 2013 年至 2018 年在我院接受同步放化疗的 150 例食管鳞状细胞癌（ESCC）患者。使用受试者工作特征曲线（ROC）定义 HALP 和 GRIm⁃Score 的截断值。采用 Kaplan-Meier 法进行生存分析，采用对数秩检验进行差异分析。采用多因素 Cox 比例风险模型评估 HALP 和 GRIm 对 ESCC 的预后意义。
结果
Hb 与 Zubrod ECOG WHO 体能状态、肿瘤部位和临床肿瘤、淋巴结、转移分期显著相关。改良 GRIm（mGRIm）仅与放疗前转移/复发显著相关（χ²=6.25）。单因素 Cox 回归分析显示，较高的 mGRIm（HR 1.9，95%CI 1.3-2.9）和较低的 HALP（HR 2.4，95%CI 1.6-3.7）均与 OS 不良相关。多因素 COX 分析发现，较高的 mGRIm 评分（HR 1.7，95%CI 1.1-2.6）和较低的 HALP 评分（HR 2，95%CI 1.3-3.2）均为总生存的独立危险因素。内部验证的列线图 c 指数为 0.66。
结论
HALP 和 mGRIm 都是不可切除 ESCC 患者的独立预后因素。
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