Zhao Zhou, Yan Menghua, Pang Huayang, Chen Lihui, Tang Xi, Chen Zhixiong, Chen Xiufeng, Sun Hao
Gastrointestinal Cancer Center, Chongqing University Cancer Hospital, Chongqing, 400030, People's Republic of China.
Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment, Chongqing University Cancer Hospital, Chongqing, 400030, People's Republic of China.
J Inflamm Res. 2024 Jun 14;17:3865-3878. doi: 10.2147/JIR.S462985. eCollection 2024.
To evaluate the predictive capacity of the nutritional-inflammatory index and clinicopathological characteristics in patients with locally advanced rectal cancer (LARC) receiving total neoadjuvant therapy (TNT).
Data from 127 patients with LARC receiving TNT from January 2017 to January 2021 were retrospectively analyzed. Clinicopathological characteristics with different TNT-induced responses were compared. The Chi-square test and the Mann-Whitney test were used to analyze the association between pre-TNT factors and TNT-induced responses. Multivariable logistic regression analysis was used to construct a predictive model.
In the cohort of 127 patients with LARC who underwent total neoadjuvant therapy (TNT), the mean age was 54.1 ± 11.4 years; 88 (69.3%) were male. Seventy patients (55.1%) exhibited a favorable response to TNT, while 57 patients (44.9%) demonstrated a poor response. Tumor characteristics, including diameter, distance from the anal verge, pre-TNT lymphocyte, pre-TNT hemoglobin, CA199, PLR, and HALP, exhibit correlations with TNT-induced tumor regression. Multivariate logistic regression analysis identified large tumor diameters (> 5.0 cm; = 0.005, HR 2.958; 95% CI 1.382-6.335) and low HALP (≤ 40; = 0.002, HR 0.261; 95% CI 0.111-0.612) as predictors of TNT-induced poor responses. Additionally, low levels of HALP were associated with an increased risk of recurrence in patients with LARC with TNT, but this was not statistically significant ( = 0.087, HR 2.008, 95% CI 0.906-4.447).
A large tumor diameter and low HALP predict poor tumor regression induced by the CAPOX-based TNT regimen in patients with LARC.
评估营养 - 炎症指数及临床病理特征对接受全新辅助治疗（TNT）的局部晚期直肠癌（LARC）患者的预测能力。
回顾性分析2017年1月至2021年1月期间127例接受TNT的LARC患者的数据。比较不同TNT诱导反应的临床病理特征。采用卡方检验和曼 - 惠特尼检验分析TNT前因素与TNT诱导反应之间的关联。使用多变量逻辑回归分析构建预测模型。
在127例接受全新辅助治疗（TNT）的LARC患者队列中，平均年龄为54.1±11.4岁；88例（69.3%）为男性。70例（55.1%）患者对TNT表现出良好反应，而57例（44.9%）患者反应较差。肿瘤特征，包括直径、距肛缘距离、TNT前淋巴细胞、TNT前血红蛋白、CA199、血小板 - 淋巴细胞比率（PLR）和宿主抗白血病反应蛋白（HALP），与TNT诱导的肿瘤退缩相关。多变量逻辑回归分析确定大肿瘤直径（>5.0 cm；P = 0.005，HR 2.958；95%CI 1.382 - 6.335）和低HALP（≤40；P = 0.002，HR 0.261；95%CI 0.111 - 0.612）是TNT诱导不良反应的预测因素。此外，低水平的HALP与接受TNT的LARC患者复发风险增加相关，但差异无统计学意义（P = 0.087，HR 2.008，95%CI 0.906 - 4.447）。
大肿瘤直径和低HALP可预测LARC患者基于CAPOX方案的TNT诱导的肿瘤退缩不良。
