Ning Yudong, Li Han, Song Yixuan, He Yuqin, Liu Shaoyan, Liu Yang
Department of Head and Neck Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Front Mol Biosci. 2025 May 1;12:1593742. doi: 10.3389/fmolb.2025.1593742. eCollection 2025.
To explore the predictive value of the combined positive score (CPS) and the neutrophil-to- platelet count ratio (NPR) for surgical pathological remission in patients with locally advanced head and neck squamous cell carcinoma (LAHNSCC) who have undergone neoadjuvant immunotherapy combined with chemotherapy (NICC).
Patients with LAHNSCC who underwent NICC and surgery from May 2021 to September 2023 were retrospectively analyzed. CPS, NPR and other clinically relevant parameters were collected, which includes gender, age, tumor types, multiple cancer, differentiation, T staging, N staging, immunotherapy cycles and postoperative pathological remission degree.
Patients with a higher CPS were significantly associated with a higher pathological complete response (PCR) of the primary site (PPCR) (P = 0.034) and a higher PCR of the lymph nodes (LPCR) (P = 0.085). Specifically, patients with a CPS of ≥20 demonstrated a higher rate of severe pathologic tumor response (PTR), with values of 80.8% compared to 66.7% and 50%. Notably, even patients with a CPS <1 had a relatively high severe PTR rate of 66.7%. Moreover, patients with NPR <0.024 exhibited a higher severe PTR, regardless of the CPS subgroups (P < 0.05).
Higher CPS can be considered a good predictor of higher PCR after NICC in patients with LAHNSCC. Patients with CPS <1 can still achieve a higher PTR. Patients with NPR <0.024 can help achieve a higher severe PTR in patients with LAHNSCC regardless of the CPS.CPS combined with NPR may have a better predicted value for surgical PTR of HNSCC after NICC.
探讨联合阳性评分（CPS）和中性粒细胞与血小板计数比值（NPR）对接受新辅助免疫治疗联合化疗（NICC）的局部晚期头颈部鳞状细胞癌（LAHNSCC）患者手术病理缓解的预测价值。
回顾性分析2021年5月至2023年9月接受NICC及手术治疗的LAHNSCC患者。收集CPS、NPR及其他临床相关参数，包括性别、年龄、肿瘤类型、多原发癌、分化程度、T分期、N分期、免疫治疗周期及术后病理缓解程度。
CPS较高的患者与原发灶病理完全缓解（PPCR）率较高（P = 0.034）及淋巴结病理完全缓解（LPCR）率较高（P = 0.085）显著相关。具体而言，CPS≥20的患者严重病理肿瘤反应（PTR）率较高，分别为80.8%，而其他组为66.7%和50%。值得注意的是，即使CPS<1的患者严重PTR率也相对较高，为66.7%。此外，无论CPS亚组如何，NPR<0.024的患者均表现出较高的严重PTR（P<0.05）。
较高的CPS可被认为是LAHNSCC患者接受NICC后较高PCR的良好预测指标。CPS<1的患者仍可实现较高的PTR。NPR<0.024的患者无论CPS如何，均有助于LAHNSCC患者实现较高的严重PTR。CPS联合NPR对NICC后HNSCC手术PTR可能具有更好的预测价值。
