Department of Clinical Oncology, Antalya Education and Research Hospital, Health Science University, 07100 Antalya, Turkey.
Department of Pathology, Cumhuriyet University School of Medicine, 58140 Sivas, Turkey.
Curr Oncol. 2024 Aug 28;31(9):5027-5039. doi: 10.3390/curroncol31090372.
This investigation evaluated the predictive and prognostic efficacy of the newly developed global immune-nutrition-inflammation index (GINI) in patients with grade 4 adult-type diffuse gliomas, comparing it with other established indices such as the systemic immune-inflammation index (SII), systemic inflammation response index (SIRI), and pan-immune-inflammation value (PIV).
A retrospective cohort included 198 patients diagnosed with isocitrate dehydrogenase (IDH)-mutant gr4 (grade 4) astrocytoma and IDH-wt (wilde-type) glioblastoma (GBM) gr4 treated with surgical resection, radiotherapy, and temozolomide. Patients were stratified into two groups based on their GINI values: low GINI (<5815) and high GINI (≥5815). The primary endpoint was overall survival (OS).
High GINI was significantly associated with older age, poor performance status, multifocal tumors, and higher SII, SIRI, and PIV values ( < 0.005). The GINI demonstrated strong correlations with SII (r = 0.694), SIRI (r = 0.516), and PIV (r = 0.657) ( < 0.001). Patients with high GINI exhibited poorer OS (5.0 vs. 17.0 months) and PFS (5.0 vs. 13.0 months) in comparison to those with low GINI. Kaplan-Meier survival analysis revealed significantly prolonged OS and PFS among patients with low GINI ( < 0.001). Multivariate analysis identified high GINI as an independent negative risk factor for both PFS and OS.
GINI is a robust predictor of clinical outcomes in IDH-mutant gr4 astrocytoma and IDH-wt GBM gr4, highlighting the crucial impact of nutrition and cancer cachexia. It shows superior prognostic value relative to the SII, SIRI, and PIV.
本研究旨在评估新开发的全身免疫-营养-炎症指数（GINI）在 4 级成人弥漫性脑胶质瘤患者中的预测和预后效能，并与其他已建立的指标（如全身炎症反应指数[SII]、全身炎症反应指数[SIRI]和全免疫炎症值[PIV]）进行比较。
本回顾性队列研究纳入了 198 例经手术切除、放疗和替莫唑胺治疗的 IDH 突变型 4 级（gr4）星形细胞瘤和 IDH 野生型（wt）胶质母细胞瘤（GBM）gr4 患者。根据 GINI 值将患者分为两组：低 GINI（<5815）和高 GINI（≥5815）。主要终点为总生存期（OS）。
高 GINI 与年龄较大、功能状态较差、多发病灶以及更高的 SII、SIRI 和 PIV 值显著相关（<0.005）。GINI 与 SII（r=0.694）、SIRI（r=0.516）和 PIV（r=0.657）呈强相关性（<0.001）。与低 GINI 组相比，高 GINI 组患者的 OS（5.0 个月与 17.0 个月）和 PFS（5.0 个月与 13.0 个月）更差。Kaplan-Meier 生存分析显示，低 GINI 组患者的 OS 和 PFS 明显延长（<0.001）。多因素分析表明，高 GINI 是 PFS 和 OS 的独立负危险因素。
GINI 是 IDH 突变型 gr4 星形细胞瘤和 IDH-wt GBM gr4 患者临床结局的有力预测指标，突出了营养和癌症恶病质的关键影响。它在预后方面优于 SII、SIRI 和 PIV。
