Clinical study on the combination of systemic immune inflammation index and neutrophil lymphocyte ratio in guiding immunotherapy for advanced gastric cancer
Clinical study on the combination of systemic immune inflammation index and neutrophil lymphocyte ratio in guiding immunotherapy for advanced gastric cancer
王振峰 1常俊朋 1隋德岭 1刘广勇1
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作者信息
1. 山东省聊城市第二人民医院普通外科，聊城 252601
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摘要
目的 分析系统免疫炎症指数(SII)联合中性粒细胞淋巴细胞比值(NLR)在晚期胃癌PD-1/PD-L1抑制剂治疗中的意义。 方法 回顾性分析2020年1月—2023年1月接受免疫治疗的90例Ⅳ期胃腺癌患者的病例资料，其中男性70例，女性20例，年龄36～80岁，平均年龄(53.76±15.58)岁。收集患者的临床病理特征及随访资料。采用SPSS 26.0软件进行统计学分析。计算NLR、SII、PLR和MLR的临界值，分析不同标志物水平患者的总生存期和无进展生存期(PFS)，确定PFS和总生存期的独立预测因素，评估危险因素对胃癌患者PFS和总生存期的预测价值。 结果 所有患者中位随访时间为27.3个月，中位PFS和总生存期分别为10.0个月和17.7个月。NLR和SII预测PFS和总生存期的曲线下面积(AUC)均>0.7，临界值NLR分别为4.75和3.85，SII分别为1154.67和887.90。高NLR、高MLR、高PLR和高SII患者的PFS和总生存期均低于低水平患者。ECOG PS≥1、高NLR和高SII是疾病进展或死亡的独立影响因素。NLR、ECOG PS和SII组合的AUC为0.761，预测效能高于任何单因素，危险因素数量越少的患者PFS和总生存期越长。 结论 在接受免疫治疗的晚期胃癌患者中，NLR和SII是PFS和总生存期的有效预测因素，治疗前检测NLR和SII能够为晚期胃癌免疫治疗提供可靠指导。 Objective To analyze the significance of systemic immune inflammatory index (SII) combined with neutrophil lymphocyte ratio (NLR) in the treatment of advanced gastric cancer with PD-1/PD-L1 inhibitors. Methods The clinical data of 90 patients with stage Ⅳ gastric adenocarcinoma who received immunotherapy from January 2020 to January 2023 were retrospectively analyzed, including 70 males and 20 females, aged from 36 to 80 years, with an average age of (53.76±15.58) years. The clinicopathological features and follow-up data were collected. SPSS 26.0 software was used to conduct statistical analysis. The critical values of NLR, SII, PLR and MLR were calculated, and the overall survival (OS) and progression free survival (PFS) of patients with different levels of markers were analyzed. The independent predictive factors of PFS and OS were determined, and the predictive value of risk factors for PFS and OS in patients with gastric cancer was evaluated. Results The median follow-up time of all patients was 27.3 months, and the median PFS and OS were 10.0 months and 17.7 months, respectively. The area under the curve (AUC) of NLR and SII for predicting PFS and OS were>0.7, the critical values NLR were 4.75 and 3.85, and SII were 1154.67 and 887.90, respectively. PFS and OS in patients with high NLR, high MLR, high PLR and high SII were lower than those in patients with low levels. ECoG PS≥ 1, high NLR and high SII were independent influencing factors of disease progression or death. The AUC of the combination of NLR, ECoG PS and SII was 0.761, which was higher than that of any single factor. The fewer the number of risk factors, the longer the PFS and OS. Conclusions NLR and SII are effective predictors of PFS and OS in patients with advanced gastric cancer receiving immunotherapy. Pre treatment detection of NLR and SII can provide reliable guidance for immunotherapy of advanced gastric cancer.
Abstract
Objective To analyze the significance of systemic immune inflammatory index (SII) combined with neutrophil lymphocyte ratio (NLR) in the treatment of advanced gastric cancer with PD-1/PD-L1 inhibitors. Methods The clinical data of 90 patients with stage Ⅳ gastric adenocarcinoma who received immunotherapy from January 2020 to January 2023 were retrospectively analyzed, including 70 males and 20 females, aged from 36 to 80 years, with an average age of (53.76±15.58) years. The clinicopathological features and follow-up data were collected. SPSS 26.0 software was used to conduct statistical analysis. The critical values of NLR, SII, PLR and MLR were calculated, and the overall survival (OS) and progression free survival (PFS) of patients with different levels of markers were analyzed. The independent predictive factors of PFS and OS were determined, and the predictive value of risk factors for PFS and OS in patients with gastric cancer was evaluated. Results The median follow-up time of all patients was 27.3 months, and the median PFS and OS were 10.0 months and 17.7 months, respectively. The area under the curve (AUC) of NLR and SII for predicting PFS and OS were>0.7, the critical values NLR were 4.75 and 3.85, and SII were 1154.67 and 887.90, respectively. PFS and OS in patients with high NLR, high MLR, high PLR and high SII were lower than those in patients with low levels. ECoG PS≥ 1, high NLR and high SII were independent influencing factors of disease progression or death. The AUC of the combination of NLR, ECoG PS and SII was 0.761, which was higher than that of any single factor. The fewer the number of risk factors, the longer the PFS and OS. Conclusions NLR and SII are effective predictors of PFS and OS in patients with advanced gastric cancer receiving immunotherapy. Pre treatment detection of NLR and SII can provide reliable guidance for immunotherapy of advanced gastric cancer.
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