新型免疫炎症指标联合血红蛋白水平（PIV/Hb）预测局部晚期鼻咽癌放化疗后张口困难发生率。

Novel Index Combining Pan-Immune-Inflammatory Index and Hemoglobin Levels (PIV/Hb) Predicts Trismus Rates Efficiently after Chemoradiotherapy in Locally Advanced Nasopharyngeal Cancer.

机构信息

Department of Oral and Maxillofacial Surgery Faculty of Dentistry Baskent University, Ankara, Türkiye.

Department of Oral and Maxillofacial Radiology School of Dental Medicine Bahcesehir University, Istanbul, Türkiye.

出版信息

Int J Surg Oncol. 2024 Sep 30;2024:2124006. doi: 10.1155/2024/2124006. eCollection 2024.

DOI:10.1155/2024/2124006

PMID:39376995

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11458266/

Abstract

PURPOSE

To evaluate the predictive potency of a novel index combining the pan-immune-inflammatory index and hemoglobin levels (PIV/Hb) for the prevalence of radiation-induced trismus (RIT) in patients with locally advanced nasopharyngeal cancer (LA-NPC) receiving concurrent chemoradiotherapy (CCRT).

METHODS

Data from 228 LA-NPC patients were retrospectively examined. Maximum mouth openings (MMO) were measured to confirm the presence of RIT, defined as MMOs ≤35 mm. Complete blood test results from the first day of CCRT were used to calculate PIV/Hb levels. A potential relationship between pretreatment PIV/Hb and the RIT status was evaluated using receiver operating characteristic (ROC) curve analysis.

RESULTS

Post-CCRT RIT was diagnosed in 20.2% of the patients. The ROC curve analysis determined 68.4 g/dL as the ideal PIV/Hb cutoff that effectively divided patients into two distinct groups (area under the curve: 94.7%; specificity: 86.4%; sensitivity: 87.4%). RIT was significantly more prevalent in the PIV/Hb > 68 group than in the PIV/Hb < 68 group (58.8% vs. 3.8%; < 0.001). Multivariate logistic regression analysis showed that a pre-CCRT PIV > 68 was independently associated with significantly higher rates of RIT.

CONCLUSION

Higher pretreatment levels of the novel PIV/Hb index predict increased RIT rates following definitive CCRT for LA-NPCs.

摘要

目的

评估一种新的联合全身免疫炎症指数和血红蛋白水平（PIV/Hb）的指标，预测接受同期放化疗（CCRT）的局部晚期鼻咽癌（LA-NPC）患者辐射诱导的张口困难（RIT）的发生率。

方法

回顾性分析 228 例 LA-NPC 患者的数据。通过测量最大张口度（MMO）来确认 RIT 的存在，定义为 MMOs≤35mm。从 CCRT 第一天的全血检查结果中计算出 PIV/Hb 水平。使用受试者工作特征（ROC）曲线分析评估预处理 PIV/Hb 与 RIT 状态之间的潜在关系。

结果

20.2%的患者在 CCRT 后被诊断为 RIT。ROC 曲线分析确定 68.4g/dL 为理想的 PIV/Hb 截断值，可将患者有效分为两组（曲线下面积：94.7%；特异性：86.4%；敏感性：87.4%）。PIV/Hb＞68 组的 RIT 发生率明显高于 PIV/Hb＜68 组（58.8% vs. 3.8%；＜0.001）。多因素 logistic 回归分析表明，CCRT 前 PIV＞68 与 RIT 发生率显著升高独立相关。