Topkan Erkan, Selek Ugur, Pehlivan Berrin, Kucuk Ahmet, Ozturk Duriye, Ozdemir Beyza Sirin, Besen Ali Ayberk, Mertsoylu Huseyin
Department of Radiation Oncology, Baskent University Medical Faculty, Adana 01120, Turkey.
Department of Radiation Oncology, Koc University School of Medicine, Istanbul 34010, Turkey.
Cancers (Basel). 2023 Sep 11;15(18):4512. doi: 10.3390/cancers15184512.
We sought to determine the prognostic value of the newly developed Global Immune-Nutrition-Inflammation Index (GINI) in patients with stage IIIC non-small cell lung cancer (NSCLC) who underwent definitive concurrent chemoradiotherapy (CCRT).
This study was conducted on a cohort of 802 newly diagnosed stage IIIC NSCLC patients who underwent CCRT. The novel GINI created first here was defined as follows: GINI = [C-reactive protein × Platelets × Monocytes × Neutrophils] ÷ [Albumin × Lymphocytes]. The receiver operating characteristic (ROC) curve analysis was used to determine the optimal pre-CCRT GINI cut-off value that substantially interacts with the locoregional progression-free (LRPFS), progression-free (PFS), and overall survival (OS).
The optimal pre-CCRT GINI cutoff was 1562 (AUC: 76.1%; sensitivity: 72.4%; specificity: 68.2%; Youden index: 0.406). Patients presenting with a GINI ≥ 1562 had substantially shorter median LRPFS (13.3 vs. 18.4 months; < 0.001), PFS (10.2 vs. 14.3 months; < 0.001), and OS (19.1 vs. 37.8 months; < 0.001) durations than those with a GINI < 1562. Results of the multivariate analysis revealed that the pre-CCRT GINI ≥ 1562 (vs. <1562), T4 tumor (vs. T3), and receiving only 1 cycle of concurrent chemotherapy (vs. 2-3 cycles) were the factors independently associated with poorer LRPS ( < 0.05 for each), PFS ( < 0.05 for each), and OS ( < 0.05 for each).
The newly developed GINI index efficiently divided the stage IIIC NSCLSC patients into two subgroups with substantially different median and long-term survival outcomes.
我们试图确定新开发的全球免疫 - 营养 - 炎症指数（GINI）在接受根治性同步放化疗（CCRT）的IIIC期非小细胞肺癌（NSCLC）患者中的预后价值。
本研究对802例新诊断的接受CCRT的IIIC期NSCLC患者进行了队列研究。在此首次创建的新型GINI定义如下：GINI = [C反应蛋白×血小板×单核细胞×中性粒细胞]÷[白蛋白×淋巴细胞]。采用受试者工作特征（ROC）曲线分析来确定与局部区域无进展生存期（LRPFS）、无进展生存期（PFS）和总生存期（OS）有显著相互作用的CCRT前最佳GINI临界值。
CCRT前最佳GINI临界值为1562（曲线下面积：76.1%；敏感性：72.4%；特异性：68.2%；约登指数：0.406）。GINI≥1562的患者的中位LRPFS（13.3个月对18.4个月；<0.001）、PFS（10.2个月对14.3个月；<0.001）和OS（19.1个月对37.8个月；<0.001）持续时间明显短于GINI<1562的患者。多变量分析结果显示，CCRT前GINI≥1562（对<1562）、T4期肿瘤（对T3期）以及仅接受1周期同步化疗（对2 - 3周期）是与较差的LRPS（各<0.05）、PFS（各<0.05）和OS（各<0.05）独立相关的因素。
新开发的GINI指数有效地将IIIC期NSCLSC患者分为两个亚组，这两个亚组的中位生存期和长期生存结果有显著差异。
