Department of Gynecology, The First Affiliated Hospital of Nanjing Medical University, No. 300 Guangzhou Road, Nanjing, Jiangsu 210029, China.
Department of Gynecology, The First Affiliated Hospital of Nanjing Medical University, No. 300 Guangzhou Road, Nanjing, Jiangsu 210029, China.
Eur J Obstet Gynecol Reprod Biol. 2024 Mar;294:97-104. doi: 10.1016/j.ejogrb.2024.01.002. Epub 2024 Jan 12.
This study was designed to investigate the relationship between the Gustave-Roussy immune score (GRIm-score) and platinum resistance in patients with advanced high-grade serous ovarian cancer (HGSOC).
We conducted a retrospective study of patients diagnosed with advanced HGSOC between January 2017 and December 2020. A nomogram was developed to predict the risk of platinum resistance. Receiver operating characteristic (ROC) curves, calibration curves, and decision curve analysis (DCA) were used to validate the nomogram. Bootstrap analysis was utilized for internal validation. Additionally, we analyzed the risk factors for platinum resistance in patients who received neoadjuvant chemotherapy (NACT).
A total of 232 patients with advanced HGSOC were included, 52 (22.4 %) of whom experienced relapse with platinum resistance. Multivariate logistic regression analysis revealed that high GRIm-score (OR = 4.174, P < 0.001), NACT (OR = 2.706, P = 0.017), PLT > 260 (OR = 2.233, P = 0.037) and non-R0 (OR = 2.526, P = 0.012) were independent risk factors for platinum resistance. The area under the curve (AUC) of the model was 0.802 (95 % CI 0.736-0.868), and the internally validated AUC of 1000 bootstrap samples was 0.798 (95 % CI 0.725-0.862). In NACT-treated patients, univariate and multivariate logistic regression analyses revealed that a low KELIM score (OR = 10.405, P = 0.001) and PLT > 260 (OR = 4.611, P = 0.014) were independent risk factors for platinum resistance.
The GRIm-score and PLT count are important prognostic factors in patients with HGSOC. For precision treatment, the status of partially platinum-sensitive patients should also be considered.
本研究旨在探讨古斯塔夫-鲁西免疫评分（GRIm-score）与晚期高级别浆液性卵巢癌（HGSOC）患者铂类耐药之间的关系。
我们对 2017 年 1 月至 2020 年 12 月期间诊断为晚期 HGSOC 的患者进行了回顾性研究。建立了一个列线图来预测铂类耐药的风险。使用接受者操作特征（ROC）曲线、校准曲线和决策曲线分析（DCA）来验证列线图。Bootstrap 分析用于内部验证。此外，我们还分析了接受新辅助化疗（NACT）的患者中铂类耐药的危险因素。
共纳入 232 例晚期 HGSOC 患者，其中 52 例（22.4%）发生铂类耐药复发。多因素 logistic 回归分析显示，高 GRIm-score（OR=4.174，P<0.001）、NACT（OR=2.706，P=0.017）、血小板（PLT）>260（OR=2.233，P=0.037）和非 R0 切除（OR=2.526，P=0.012）是铂类耐药的独立危险因素。模型的曲线下面积（AUC）为 0.802（95%CI 0.736-0.868），1000 个 bootstrap 样本的内部验证 AUC 为 0.798（95%CI 0.725-0.862）。在接受 NACT 治疗的患者中，单因素和多因素 logistic 回归分析显示，低 KELIM 评分（OR=10.405，P=0.001）和 PLT>260（OR=4.611，P=0.014）是铂类耐药的独立危险因素。
GRIm-score 和 PLT 计数是 HGSOC 患者的重要预后因素。为了进行精准治疗，还应考虑部分铂类敏感患者的情况。
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