晚期子宫内膜癌免疫检查点抑制剂治疗的潜在预后预测指标。

Potential prognostic predictors of treatment with immune checkpoint inhibitors for advanced endometrial cancer.

作者信息

Yanazume Shintaro, Nagata Chikako, Kobayashi Yusuke, Fukuda Mika, Mizuno Mika, Togami Shinichi, Kobayashi Hiroaki

机构信息

Department of Obstetrics and Gynecology, Faculty of Medicine, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima 890-8520, Japan.

出版信息

Jpn J Clin Oncol. 2025 Jan 8;55(1):29-35. doi: 10.1093/jjco/hyae123.

DOI:10.1093/jjco/hyae123

PMID:39225428

Abstract

BACKGROUND

Prognostic predictors of immunotherapy in patients with advanced endometrial cancer remain unclear. The potential role of inflammatory predictors, including pretreatment neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio and hemoglobin, albumin, lymphocyte and platelet scores, was investigated.

METHODS

Between August 2018 and December 2023, 35 patients were retrospectively analyzed. Prognostic predictors were compared, and optimal cut-off values that exhibited the greatest discrimination for overall response, disease control, progression-free survival and overall survival were determined. Multivariate analysis was used to assess the prognostic significance of the predictors.

RESULTS

The greatest discrimination for overall response, progression-free survival and overall survival included platelet-to-lymphocyte ratio, neutrophil-to-lymphocyte ratio and hemoglobin, albumin, lymphocyte and platelet; the areas under the curve were 0.638, 0.649 and 0.641, respectively. The precise cut-off values of neutrophil-to-lymphocyte ratio for progression-free survival and overall survival were 4.92 and 5.40, respectively. The lower neutrophil-to-lymphocyte ratio group had a significantly longer progression-free survival (P = 0.001, median survival; 4.0 months vs. 19 months) and longer overall survival (P = 0.002, median survival; 5.0 months vs. 21 months). Of the risk factors assessed, neutrophil-to-lymphocyte ratio (hazard ratio = 4.409; 95% CI = 1.10-17.64; P = 0.036) and regimen (hazard ratio = 5.559; 95% CI = 1.26-24.49; P = 0.023) were independently correlated with overall survival.

CONCLUSION

In patients with advanced endometrial cancer, pretreatment neutrophil-to-lymphocyte ratio may be a prognostic predictor of those who would benefit from immunotherapy.

摘要

背景

晚期子宫内膜癌患者免疫治疗的预后预测指标仍不明确。本研究调查了包括治疗前中性粒细胞与淋巴细胞比值、血小板与淋巴细胞比值以及血红蛋白、白蛋白、淋巴细胞和血小板评分在内的炎症预测指标的潜在作用。

方法

回顾性分析2018年8月至2023年12月期间的35例患者。比较预后预测指标，确定对总体反应、疾病控制、无进展生存期和总生存期具有最大区分度的最佳临界值。采用多变量分析评估预测指标的预后意义。

结果

对总体反应、无进展生存期和总生存期具有最大区分度的指标包括血小板与淋巴细胞比值、中性粒细胞与淋巴细胞比值以及血红蛋白、白蛋白、淋巴细胞和血小板；曲线下面积分别为0.638、0.649和0.641。无进展生存期和总生存期的中性粒细胞与淋巴细胞比值的精确临界值分别为4.92和5.40。中性粒细胞与淋巴细胞比值较低的组无进展生存期显著更长（P = 0.001，中位生存期；4.0个月对19个月），总生存期也更长（P = 0.002，中位生存期；5.0个月对21个月）。在评估的危险因素中，中性粒细胞与淋巴细胞比值（风险比 = 4.409；95%置信区间 = 1.10 - 17.64；P = 0.036）和治疗方案（风险比 = 5.559；95%置信区间 = 1.26 - 24.49；P = 0.023）与总生存期独立相关。