不可切除的晚期胃癌患者接受免疫检查点抑制剂联合化疗时炎症和营养指标的预后价值——一项回顾性研究

Prognostic value of inflammatory and nutritional indexes among patients with unresectable advanced gastric cancer receiving immune checkpoint inhibitors combined with chemotherapy-a retrospective study.

作者信息

Zhu Meiqin, Zhang Lin-Ting, Lai Wenjuan, Yang Fang, Zhou Danyang, Xu Ruilian, Tong Gangling

机构信息

Department of Medical Oncology, Shenzhen People's Hospital, The Second Clinical Medical College, Jinan University, The First Affiliated Hospital, Southern University of Science and Technology, Shenzhen, Guangdong, China.

Department of Oncology, Peking University Shenzhen Hospital, Shenzhen, Guangdong, China.

出版信息

PeerJ. 2024 Dec 17;12:e18659. doi: 10.7717/peerj.18659. eCollection 2024.

DOI:10.7717/peerj.18659

PMID:39713151

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11660861/

Abstract

BACKGROUND

Recent studies have revealed that inflammatory factors and nutritional status of patients with advanced gastric cancer (AGC) are related to the efficacy of drug therapy and patient prognosis. This study seeks to evaluate the correlation between inflammatory markers, nutritional status, and clinical outcomes of immune checkpoint inhibitor (ICI)-based therapies among inoperable AGC patients.

METHOD

This retrospective study included 88 AGC patients who received ICIs combined with chemotherapy. Inflammatory and nutritional indicators from patients before and after two cycles of treatment were collected. Finally, the correlations between these indicators and the clinical response and survival of AGC patients with ICI treatment were examined.

RESULTS

The results revealed that an Eastern Cooperative Oncology Group performance status (ECOG PS) score of 0, neutrophil count to lymphocyte count ratio (NLR) < 2.84, platelet count to lymphocyte count ratio (PLR) < 82.23, lymphocyte count to monocyte count ratio ≥ 2.35, the hemoglobin, albumin, lymphocyte and platelet score (HALP) ≥ 31.17, prognostic nutritional index (PNI) ≥ 46.53, albumin ≥ 41.65, the decreased HALP group and the decreased PNI group were significantly correlated with improved objective response rate. Additionally, an ECOG PS score of 0, NLR < 2.84 and the decreased HALP group was associated with a superior disease control rate. Meanwhile, an ECOG PS score of 0 (progression-free survival (PFS): = 0.003; overall survival (OS): = 0.001) and decreased PLR following treatment (PFS: = 0.011; OS: = 0.008) were significant independent predictors of PFS and OS. Lastly, a systemic immune inflammation index ≥ 814.8 was also a positive independent predictor of OS among AGC patients.

CONCLUSION

Our study supports the potential of inflammatory and nutritional factors to serve as predictors of the efficacy and prognosis in patients undergoing ICI-based therapies for AGC. However, further investigations are necessary to validate these findings.

摘要

背景

近期研究表明，晚期胃癌（AGC）患者的炎症因子和营养状况与药物治疗疗效及患者预后相关。本研究旨在评估不可切除AGC患者中炎症标志物、营养状况与基于免疫检查点抑制剂（ICI）治疗的临床结局之间的相关性。

方法

本回顾性研究纳入了88例接受ICI联合化疗的AGC患者。收集患者两个周期治疗前后的炎症和营养指标。最后，检验这些指标与接受ICI治疗的AGC患者临床反应和生存之间的相关性。

结果

结果显示，东部肿瘤协作组体能状态（ECOG PS）评分为0、中性粒细胞计数与淋巴细胞计数比值（NLR）<2.84、血小板计数与淋巴细胞计数比值（PLR）<82.23、淋巴细胞计数与单核细胞计数比值≥2.35、血红蛋白、白蛋白、淋巴细胞和血小板评分（HALP）≥31.17、预后营养指数（PNI）≥46.53、白蛋白≥41.65、HALP降低组和PNI降低组与客观缓解率提高显著相关。此外，ECOG PS评分为0、NLR<2.84和HALP降低组与更高的疾病控制率相关。同时，ECOG PS评分为0（无进展生存期（PFS）： =0.003；总生存期（OS）： =0.001）以及治疗后PLR降低（PFS： =0.011；OS： =0.008）是PFS和OS的显著独立预测因素。最后，全身免疫炎症指数≥814.8也是AGC患者OS的阳性独立预测因素。