PLR NLR及CA199与免疫治疗晚期胃癌患者预后的关系研究

doi:10.3969/j.issn.1006-6233.2024.10.015

摘要
图/表
参考文献
相关文章 (15)

全文: PDF (1639 KB) HTML (1 KB)
输出: BibTeX | EndNote (RIS)

摘要 目的:研究血小板与淋巴细胞比值(PLR)、中性粒细胞与淋巴细胞比值(NLR)及肿瘤标志物糖类抗原199(CA199)与免疫检查点抑制剂(ICI)治疗晚期胃癌患者预后的关系。方法:回顾性分析2022年1月至2024年3月本院收治的103例晚期胃癌患者接受ICI治疗后的临床资料,随访时间截止至2024年6月,收集患者治疗前PLR、NLR、CA199等检验指标,以疾病进展为状态变量,绘制PLR、NLR、CA199等检验指标与晚期胃癌患者接受ICI治疗后的生存特征曲线(ROC),获取截断值,分别将患者分为高PLR组、低PLR组、高NLR组、低NLR组、高CA199组、低CA199组,采用Kaplan-Meier统计方法绘制不同组别的生存曲线,采用Cox比例风险回归模型分析影响晚期胃癌患者接受ICI治疗中位无进展生存期(PFS)的危险因素。结果:通过ROC曲线可知,PLR、NLR、CA199的截断值分别为252.47、3.39、43.63U/mL,根据获取截断值将患者分为高PLR组(n=58)、低PLR组(n=45)、高NLR组(n=50)、低NLR组(n=53)、高CA199组(n=49)、低CA199组(n=54);Kaplan-Meier分析显示,高PLR组PFS为8.8个月,低PLR组PFS为11.1个月,两组生存曲线比较差异无统计学意义(P>0.05);高NLR组、高CA199组中位PFS分别为7.2个月、7.8个月,低NLR组、低CA199组中位PFS分别为11.9个月、11.6个月,两组生存曲线比较差异有统计学意义(P<0.05);单因素Cox回归分析显示,年龄≥65岁、ECOG PS≥1分、高PLR、高NLR、高CA199与晚期胃癌患者接受ICI治疗后的PFS缩短有关(P<0.05);多因素Cox回归分析显示,ECOG PS≥1分、高NLR、高CA199是影响晚期胃癌患者接受ICI治疗后PFS的独立危险因素(P<0.05)。结论:治疗前PLR、NLR、CA199指标与晚期胃癌患者接受ICI治疗的预后有关,治疗前NLR、CA199是影响患者PFS的独立危险因素,监测以上指标有利于为晚期胃癌患者接受ICI治疗提供临床指导。

	服务

	把本文推荐给朋友
	加入我的书架
	加入引用管理器
	E-mail Alert
	RSS
	作者相关文章

关键词 ：血小板与淋巴细胞比值, 中性粒细胞与淋巴细胞比值, 糖类抗原199, 晚期胃癌, 免疫治疗, 预后

Abstract：Objective: To investigate the relationship between platelet-to-lymphocyte ratio (PLR), neutrophil-to-lymphocyte ratio (NLR), carbohydrate antigen 199 (CA199), and prognosis in advanced gastric cancer patients undergoing immune checkpoint inhibitor (ICI) therapy. Methods: A retrospective analysis was conducted on 103 advanced gastric cancer patients who received ICI treatment at our hospital from January 2022 to March 2024, with follow-up until June 2024. Pre-treatment PLR, NLR, and CA199 levels were collected. The ROC curves for these indicators were plotted against disease progression, and cutoff values were determined. Patients were divided into high and low PLR, NLR, and CA199 groups based on these values. Kaplan-Meier survival curves were plotted for each group, and the Cox proportional hazards regression model was used to analyze factors influencing the median progression-free survival (PFS) of these patients. Results: The ROC curve analysis identified cutoff values for PLR, NLR, and CA199 as 252.47, 3.39, and 43.63 U/mL, respectively. Based on these cutoff values, patients were divided into high PLR (n=58), low PLR (n=45), high NLR (n=50), low NLR (n=53), high CA199 (n=49), and low CA199 (n=54) groups. Kaplan-Meier analysis showed no statistically significant difference in PFS between the high PLR group (8.8 months) and the low PLR group (11.1 months) (P>0.05). However, the high NLR group (7.2 months) and high CA199 group (7.8 months) had significantly shorter PFS compared to the low NLR group (11.9 months) and low CA199 group (11.6 months) (P<0.05). Univariate Cox regression analysis showed that age ≥65 years, ECOG PS ≥1, high PLR, high NLR, and high CA199 were associated with shorter PFS in advanced gastric cancer patients undergoing ICI therapy (P<0.05). Multivariate Cox regression analysis identified ECOG PS ≥1, high NLR, and high CA199 as independent risk factors for PFS in these patients (P<0.05). Conclusion: Pre-treatment PLR, NLR, and CA199 levels are associated with the prognosis of advanced gastric cancer patients receiving ICI therapy, with NLR and CA199 being independent risk factors for PFS. Monitoring these indicators may provide clinical guidance for the treatment of advanced gastric cancer.

Key words： Platelet-to-lymphocyte ratio Neutrophil-to-lymphocyte ratio Carbohydrate antigen 199 Advanced gastric cancer Immunotherapy Prognosis

基金资助:2020年度安徽省自然科学基金项目,(编号:2008085J29)

引用本文:

武琳琳, 汤雷, 张艳, 魏元东, 宗恒, 李凡, 魏南. PLR NLR及CA199与免疫治疗晚期胃癌患者预后的关系研究[J]. 河北医学, 2024, 30(10): 1666-1670.
WU Linlin, TANG Lei, ZHANG Yan, et al. Study on the Relationship Between PLR NLR CA199 and Prognosis in Advanced Gastric Cancer Patients Undergoing Immunotherapy. HeBei Med, 2024, 30(10): 1666-1670.

链接本文:

http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2024.10.015 或 http://www.hbyxzzs.cn/CN/Y2024/V30/I10/1666

[1] Yap DWT,Leone AG,Wong NZH,et al.Effectiveness of immune checkpoint inhibitors in patients with advanced esophageal squamous cell carcinoma: a meta-analysis including low PD-L1 subgroups[J].JAMA Oncol,2023,9(2):215-224.
[2] Zhu Y,Zhao W,Mao G.Perioperative lymphocyte-to-monocyte ratio changes plus CA199 in predicting the prognosis of patients with gastric cancer[J].Gastrointest Oncol,2022,13(3):1007-1021.
[3] Mandaliya H,Jones M,Oldmeadow C,et al.Prognostic biomarkers in stage IV non-small cell lung cancer (NSCLC): neutrophil to lymphocyte ratio (NLR),lymphocyte to monocyte ratio (LMR),platelet to lymphocyte ratio (PLR) and advanced lung cancer inflammation index (ALI)[J].Transl Lung Cancer Res,2019,8(6):886-894.
[4] Chen LC,Li SH,Lo CM,et al.Platelet-to-lymphocyte ratio is an independent prognosticator in patients with esophageal squamous cell carcinoma receiving esophagectomy[J].Thorac Dis,2019,11(11):4583-4590.
[5] Azam F,Latif MF,Farooq A,et al.Performance status assessment by using ECOG (eastern cooperative oncology group) score for cancer patients by oncology healthcare professionals[J].Case Rep Oncol,2019,12(3):728-736.
[6] 曹毛毛,李贺,孙殿钦,等.2000年至2019年中国胃癌流行病学趋势分析[J].中华消化外科杂志,2021,20(1):102-109.
[7] 李宁,吴鹏,申郁冰,等.2020年至2030年中国4种主要癌症相关死亡率的预测[J].癌症,2022,41(1):8-17.
[8] Muangto T,Maireang K,Poomtavorn Y,et al.Study on preoperative neutrophil/lymphocyte (NLR) and platelet/lymphocyte ratio (PLR) as a predictive factor in endometrial cancer[J].Asian Pac Cancer Prev,2022,23(10):3317-3322.
[9] 刘璐雯,邓思思,周晴晴,等.NLR、PLR与高级别浆液性卵巢癌分期、BRCA突变及淋巴结转移、HRD状态的关系[J].临床与实验病理学杂志,2023,39(3):261-264,270.
[10] 毛富巍,曹英豪,邓胜和,等.基于NLR、PLR、WLR、MLR的系统炎症标志物评分与结直肠癌患者术后生存时间的相关性[J].华中科技大学学报(医学版),2022,51(2):229-234.
[11] Zhao G,Liu N,Wang S,et al.Prognostic significance of the neutrophil-to-lymphocyte and platelet-to-lymphocyte ratio in patients with metastatic gastric cancer[J].Medicine (Baltimore),2020,99(10):19405.