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免疫检查点抑制剂和酪氨酸激酶抑制剂治疗男性肝细胞癌患者的预后意义与腰大肌指数的关系。

Prognostic significance of psoas muscle index in male hepatocellular carcinoma patients treated with immune checkpoint inhibitors and tyrosine kinase inhibitors.

机构信息

Department of Infectious Diseases, Key Laboratory of Molecular Biology for Infectious Diseases (Ministry of Education), Institute for Viral Hepatitis, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, China.

Department of Radiology of the Second Affiliated Hospital, Chongqing Medical University, Chongqing, China.

出版信息

Hum Vaccin Immunother. 2023 Aug;19(2):2258567. doi: 10.1080/21645515.2023.2258567. Epub 2023 Sep 20.

Abstract

Currently, the relationship between nutritional indices and the prognosis of hepatocellular carcinoma (HCC) patients treated with immune checkpoint inhibitors (ICIs) and tyrosine kinase inhibitors (TKIs) remains unclear. This study aims to investigate the prognostic value of psoas muscle index (PMI), prognostic nutritional index (PNI), body mass index (BMI), and geriatric nutritional risk index (GNRI) in HCC patients treated with ICIs combined with TKIs. A total of 124 male patients with HCC were included in this study. PNI, PMI, BMI, and GNRI were calculated at the beginning of treatment. The Cox proportional hazards model was used to analyze the effect of various variables. In the univariate analysis, PMI, PNI, GNRI, and ALB were found to impact the outcomes of the patients at different follow-up times. However, the predictive value of these nutritional indices was eliminated when established risk factors were considered. In the multivariate analysis that only included nutrition-related indicators, PMI emerged as an independent prognostic factor for 1-year treatment outcomes. The group with low PMI (≤5.5409 cm/m) was found to have a higher risk of death at one year and at the end of the follow-up period.

摘要

目前,营养指数与接受免疫检查点抑制剂(ICI)和酪氨酸激酶抑制剂(TKI)治疗的肝细胞癌(HCC)患者预后之间的关系尚不清楚。本研究旨在探讨在接受 ICI 联合 TKI 治疗的 HCC 患者中,腰大肌指数(PMI)、预后营养指数(PNI)、体重指数(BMI)和老年营养风险指数(GNRI)的预后价值。共纳入 124 名男性 HCC 患者。在治疗开始时计算 PNI、PMI、BMI 和 GNRI。使用 Cox 比例风险模型分析各种变量的影响。在单因素分析中,发现 PMI、PNI、GNRI 和 ALB 在不同随访时间对患者的预后有影响。然而,当考虑到已建立的风险因素时,这些营养指标的预测价值被消除。在仅包含营养相关指标的多因素分析中,PMI 是 1 年治疗结果的独立预后因素。PMI 较低(≤5.5409 cm/m)的组在 1 年和随访期末死亡的风险更高。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7f42/10512869/26f43728a0a8/KHVI_A_2258567_F0001_B.jpg

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