Baba Yoshifumi, Nakagawa Shigeki, Toihata Tasuku, Harada Kazuto, Iwatsuki Masaaki, Hayashi Hiromitsu, Miyamoto Yuji, Yoshida Naoya, Baba Hideo
From the Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan.
Department of Next-Generation Surgical Therapy Development, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan.
Ann Surg Open. 2021 Dec 22;3(1):e113. doi: 10.1097/AS9.0000000000000113. eCollection 2022 Mar.
MINI-ABSTRACT: The pan-immune-inflammation value was associated with clinical outcomes and tumor-infiltrating lymphocytes in 866 esophageal cancers. Systemic immune competence may influence patient prognosis through local immune response.
To examine the relationship between the pan-immune-inflammation value (PIV), tumor immunity, and clinical outcomes in 866 patients with esophageal cancer.
The PIV, calculated from all immune-inflammatory cells in the peripheral blood count, is a recently proposed marker for clinical outcomes in some types of cancers. Nonetheless, the prognostic significance of PIV in esophageal cancer remains unclear.
In the derivation cohort (n = 433), we set the optimal cutoff value using a time-dependent receiver operating characteristic (ROC) curve. In the validation cohort (n = 433), the relationships between the PIV, tumor-infiltrating lymphocytes (TILs), CD8 expression by immunohistochemical staining, and patient prognosis were examined.
The area under the ROC curve for the PIV at 5 years was 0.631 in the derivation cohort. The validation cohort, divided into PIV-low cases (n = 223) and PIV-high cases (n = 210), showed significantly worse overall survival (log-rank = 0.0065; hazard ratio [HR]: 1.48; 95% confidence interval [CI]: 1.12-1.98; < 0.001; multivariate HR: 1.41; 95% CI: 1.05-1.90; = 0.023). The prognostic effect of the PIV was not significantly modified by any clinical characteristics ( for interaction > 0.05). The PIV-high cases were significantly associated with a low TIL status ( < 0.001) and low CD8-positive cell counts ( = 0.011).
The PIV was associated with clinical outcomes in esophageal cancer, supporting its role as a prognostic biomarker. Considering the relationship between the PIV and TILs, systemic immune competence may influence patient prognosis through a local immune response.
在866例食管癌患者中，全免疫炎症值与临床结局及肿瘤浸润淋巴细胞相关。全身免疫能力可能通过局部免疫反应影响患者预后。
探讨866例食管癌患者的全免疫炎症值（PIV）、肿瘤免疫与临床结局之间的关系。
PIV由外周血细胞计数中的所有免疫炎症细胞计算得出，是最近提出的某些类型癌症临床结局的标志物。然而，PIV在食管癌中的预后意义仍不明确。
在推导队列（n = 433）中，我们使用时间依赖性受试者工作特征（ROC）曲线设定最佳临界值。在验证队列（n = 433）中，研究PIV、肿瘤浸润淋巴细胞（TILs）、免疫组化染色CD8表达与患者预后之间的关系。
推导队列中PIV在5年时的ROC曲线下面积为0.631。验证队列分为PIV低组（n = 223）和PIV高组（n = 210），结果显示PIV高组的总生存期显著更差（对数秩检验 = 0.0065；风险比[HR]：1.48；95%置信区间[CI]：1.12 - 1.98；P < 0.001；多变量HR：1.41；95% CI：1.05 - 1.90；P = 0.023）。PIV的预后效应未因任何临床特征而有显著改变（交互作用P > 0.05）。PIV高组与低TIL状态（P < 0.001）和低CD8阳性细胞计数（P = 0.011）显著相关。
PIV与食管癌临床结局相关，支持其作为预后生物标志物的作用。考虑到PIV与TILs之间的关系，全身免疫能力可能通过局部免疫反应影响患者预后。
