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免疫营养性炎症标志物在接受放化疗联合免疫治疗的食管癌中的预后价值

Prognostic value of immunotrophic inflammatory markers in ESCC undergoing chemoradiotherapy combined with immunotherapy.

作者信息

Li Youmei, Wang Hesong, Zhao Xiaohan, Deng Wenzhao, Song Chunyang, Wen Jingyuan, Zhu Shuchai, Shen Wenbin

机构信息

Department of Radiation Oncology, The Fourth Hospital of Hebei Medical University, 12 Jiankang Road, Shijiazhuang, 050011, Hebei Province, People's Republic of China.

出版信息

Sci Rep. 2025 May 25;15(1):18258. doi: 10.1038/s41598-025-02454-5.

Abstract

This study aimed to investigate the role of immunotrophic inflammatory markers in assessing the prognosis and treatment-related toxicity in patients with esophageal squamous cell carcinoma (ESCC) undergoing first-line radiotherapy and chemotherapy combined with immunotherapy. We retrospectively enrolled 67 patients with ESCC and determined the optimal cutoff values for prognostic nutrition index (PNI), neutrophil to lymphocyte ratio (NLR), and platelet to lymphocyte ratio (PLR) using receiver operating characteristic (ROC) curve analysis. Statistical analysis was performed using SPSS 25.0. The one-, two-, and three-year overall survival (OS) rates were 88.1%, 62.3%, and 57.6%, respectively. The overall effective rate was 82.1% (55/67). ROC curve analysis revealed optimal cutoff values for PNI, NLR, and PLR as 48.35, 3.84, and 150.49, respectively. Patients in the high PNI group, low NLR group and PLR group exhibited significantly higher mOS and mPFS time compared to the control group. Notably, the incidence of grade 2 toxicity and side effects in the PNI ≥ 48.35 group was significantly lower than that in the PNI < 48.35 group. Our findings suggest that pretreatment values of PNI, NLR, and PLR can serve as valuable biomarkers for evaluating the prognosis of ESCC patients undergoing first-line radiotherapy and chemotherapy combined with immunotherapy. Further studies with larger cohorts are warranted to validate these results.

摘要

本研究旨在探讨免疫营养炎性标志物在评估接受一线放疗、化疗联合免疫治疗的食管鳞状细胞癌(ESCC)患者的预后及治疗相关毒性中的作用。我们回顾性纳入了67例ESCC患者,并使用受试者工作特征(ROC)曲线分析确定了预后营养指数(PNI)、中性粒细胞与淋巴细胞比值(NLR)和血小板与淋巴细胞比值(PLR)的最佳截断值。使用SPSS 25.0进行统计分析。1年、2年和3年总生存率(OS)分别为88.1%、62.3%和57.6%。总有效率为82.1%(55/67)。ROC曲线分析显示PNI、NLR和PLR的最佳截断值分别为48.35、3.84和150.49。与对照组相比,高PNI组、低NLR组和PLR组患者的中位总生存期(mOS)和中位无进展生存期(mPFS)时间显著更长。值得注意的是,PNI≥48.35组2级毒性和副作用的发生率显著低于PNI<48.35组。我们的研究结果表明,PNI、NLR和PLR的预处理值可作为评估接受一线放疗、化疗联合免疫治疗的ESCC患者预后的有价值生物标志物。需要进一步开展更大样本量的队列研究来验证这些结果。

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