Harbin Medical University Cancer Hospital, Harbin Medical University, Harbin, China.
Medicine (Baltimore). 2024 Apr 26;103(17):e37863. doi: 10.1097/MD.0000000000037863.
The nutritional status is closely linked to the immune function of patients. Previous studies have demonstrated the utility of the Geriatric Nutritional Risk Index (GNRI) in assessing nutritional status. The aim of this study is to investigate the prognostic significance of GNRI in patients with gastric cancer who received immune checkpoint inhibitor (ICI) therapy. The study enrolled 89 gastric cancer patients who received different types of immune checkpoint inhibitors (ICIs) between August 2016 and December 2020, along with 57 patients who underwent chemotherapy during the same period as a control group. The GNRI cutoff point was established based on prior research. Differences in clinical and pathological features were analyzed using the Chi-square test or independent samples t-test. Univariate and multivariate analyses were used to identify prognostic factors for both progression-free survival (PFS) and overall survival (OS). Furthermore, nomograms were created to predict the likelihood of patient survival. There were 31 cases (21.2%) with GNRI < 92.00 and 115 cases (78.8%) with GNRI ≥ 92.00. Patients with low GNRI had significantly shorter PFS (21.33 months vs 28.37 months, P = .001) and OS (33.06 months vs 41.63 months, P = .001) than those with high GNRI, among all patients. Similar results were also found in patients treated with ICIs. Additionally, GNRI was identified as an independent prognostic factor. The C-index and 95% CI of the nomograms for predicting survival probabilities were 0.667 (0.600-0.735) and 0.685 (0.622-0.749), respectively. GNRI was significantly associated with survival time in patients with gastric cancer who received ICIs, patients with low GNRI had shorter PFS and OS. GNRI might be able to identify patients who might benefit from ICIs.
营养状况与患者的免疫功能密切相关。既往研究表明，老年营养风险指数（GNRI）在评估营养状况方面具有一定的作用。本研究旨在探讨 GNRI 在接受免疫检查点抑制剂（ICI）治疗的胃癌患者中的预后意义。该研究纳入了 89 例 2016 年 8 月至 2020 年 12 月期间接受不同类型免疫检查点抑制剂（ICI）治疗的胃癌患者，并纳入了同期接受化疗的 57 例患者作为对照组。根据既往研究确定 GNRI 截断值。采用卡方检验或独立样本 t 检验分析临床和病理特征的差异。采用单因素和多因素分析确定无进展生存期（PFS）和总生存期（OS）的预后因素。此外，还创建了列线图来预测患者生存的可能性。有 31 例（21.2%）患者的 GNRI＜92.00，115 例（78.8%）患者的 GNRI≥92.00。低 GNRI 患者的 PFS（21.33 个月比 28.37 个月，P=0.001）和 OS（33.06 个月比 41.63 个月，P=0.001）明显短于高 GNRI 患者，在所有患者中均如此。在接受 ICI 治疗的患者中也发现了类似的结果。此外，GNRI 是独立的预后因素。预测生存概率的列线图的 C 指数和 95%CI 分别为 0.667（0.600-0.735）和 0.685（0.622-0.749）。GNRI 与接受 ICI 治疗的胃癌患者的生存时间显著相关，GNRI 较低的患者 PFS 和 OS 较短。GNRI 可能能够识别可能从 ICI 中获益的患者。
