首页|PLR NLR及CA199与免疫治疗晚期胃癌患者预后的关系研究

PLR NLR及CA199与免疫治疗晚期胃癌患者预后的关系研究

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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。
Study on the Relationship Between PLR NLR CA199 and Prognosis in Advanced Gastric Cancer Patients Undergoing Immunotherapy
Objective:To investigate the relationship between platelet-to-lymphocyte ratio(PLR),neu-trophil-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 col-lected.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.Re-sults: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 iden-tified 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.

Platelet-to-lymphocyte ratioNeutrophil-to-lymphocyte ratioCarbohydrate antigen 199Advanced gastric cancerImmunotherapyPrognosis

武琳琳、汤雷、张艳、魏元东、宗恒、李凡、魏南

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安徽省第二人民医院,安徽 合肥 230041

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

2020年度安徽省自然科学基金项目

2008085J29

2024

河北医学
河北省医学会

河北医学

CSTPCD
影响因子:1.915
ISSN:1006-6233
年,卷(期):2024.30(10)