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治疗前泛免疫炎症值预测食管癌术后辅助放疗患者预后的价值

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  • 国家科技期刊平台
  • NETL
  • NSTL
  • 万方数据
目的 探讨接受术后辅助放疗的食管鳞状细胞癌患者治疗前泛免疫炎症值(PIV)与临床病理特征的相关性，并联合T分期评估其在食管鳞癌患者预后中的价值。方法 回顾性收集2019年1月-2023年1月在扬州大学附属医院放射肿瘤科行术后辅助放疗的食管鳞癌患者85例的临床资料。绘制受试者工作特征(ROC)曲线获取PIV和其他免疫炎症生物标志物的最佳临界值，依据ROC曲线及决策曲线分析(DCA)比较PIV和其他免疫炎症生物标志物的曲线下面积(AUC)及临床适用性;根据最佳临界值将患者分为PIV高水平组和PIV低水平组，评估PIV水平与食管鳞癌临床病理特征的相关性。生存分析采用Kaplan-Meier法，多因素分析采用Cox比例风险模型，并通过递归分区分析(RPA)建立一个结合PIV和T分期的风险分层模型。结果 根据ROC曲线确定治疗前PIV最佳临界值为187。22，PIV的ROC曲线的AUC(0。679)大于其他4项[全身免疫炎症指数(SII)、血小板与淋巴细胞比值(PLR)、单核细胞与淋巴细胞比值(MLR)、中性粒细胞与淋巴细胞比值(NLR)]免疫炎症生物标志物(0。640、0。583、0。656、0。644)。将85例患者分为PIV低水平组(＜187。22)48例和PIV高水平组(≥187。22)37例，PIV的水平高低与肿瘤直径相关(P＜0。05)。PIV低水平组3年总生存期(OS)(75。6％与30。6％，P＜0。001)和3年无病生存期(DFS)(56。1％与21。0％，P＜0。001)高于PIV高水平组;肿瘤直径、T分期和PIV是食管鳞癌患者OS的独立影响因素(P＜0。05)，T分期和PIV是食管鳞癌患者DFS的独立影响因素(P＜0。05)。采用基于T分期和PIV的RPA分层模型建立了一个包含3个风险组的新分期，与单独的T分期或PIV相比，基于RPA生成的模型可进一步提高对预后的预测价值。结论 治疗前PIV有助于预测术后辅助放疗食管鳞癌患者预后，PIV联合T分期可提高预测价值。
Value of pre-treatment pan-immune inflammation score in predicting prognosis of esophageal cancer patients with postoperative adjuvant radiotherapy
Objective To investigate the correlation between pre-treatment pan-immune inflam-mation value(PIV)and clinicopathological features in esophageal squamous cell carcinoma(ESCC)patients with postoperative adjuvant radiotherapy and evaluate its value in prognosis assessment com-bined with T stage.Methods A retrospective analysis was conducted on data of 85 ESCC patients with postoperative adjuvant radiotherapy in the Department of Radiation Oncology of the Affiliated Hospital of Yangzhou University from January 2019 to January 2023.The receiver operating character-istic(ROC)curve was drew to obtain the optimal cut-off value of PIV and other immune-inflammatory biomarkers.The area under the curve(AUC)and clinical applicability of PIV and other immune-in-flammatory biomarkers were compared based on the ROC curve and decision curve analysis(DC A).According to the optimal cut-off value,patients were divided into high PIV group and low PIV group,and the correlation between PIV level and clinicopathological features of ESCC was evaluated.Kaplan-Meier method was used for survival analysis,the Cox proportional hazards model was used for multivariate analysis,and a risk stratification model combining PIV and T stage was established by recursive partitioning analysis(RPA).Results The optimal cut-off value of pre-treatment PIV was determined as 187.22 based on the ROC curve.The AUC of PIV was 0.679,which was greater than 0.640,0.583,0.656 and 0.644 of the other four immune-inflammatory biomarkers such as the systemic immune-inflammation index(SII),platelet-to-lymphocyte ratio(PLR),monocyte-to-lymphocyte ratio(MLR),and neutrophil-to-lymphocyte ratio(NLR).The 85 patients were divided into low PIV group(＜187.22,n=48)and high PIV group(≥187.22,n=37).The level of PIV was significantly correlated with tumor diameter(P＜0.05).The 3-year overall survival(OS)(75.6％versus 30.6％,P＜0.001)and 3-year disease-free survival(DFS)(56.1％versus 21.0％,P＜0.001)were significantly higher in the low PIV group than the high PIV group.Tumor diameter,T stage and PIV were independent factors affecting OS in ESCC patients(P＜0.05),and T stage and PIV were independent factors affecting DFS in ESCC patients(P＜0.05).A new stag-ing system with three risk groups was established by the RPA stratification model based on T stage and PIV,which further improved the predictive value of prognosis compared with T stage or PIV alone.Conclusion Pre-treatment PIV is helpful in predicting the prognosis of ESCC patients with postoper-ative adjuvant radiotherapy,and the combination of PIV and T stage can improve the predictive value.

esophageal squamous cell carcinomapostoperative adjuvant radiotherapyclini-copathological featuresprognosispan-immune inflammation valuerecursive partitioning analysis

江美南、李添翼、任粤、宋震亚、李梦扬、陈勇、殷旭东

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扬州大学附属医院肿瘤科,江苏扬州,225000

食管鳞状细胞癌 术后辅助放疗 临床病理特征 预后 泛免疫炎症值 递归分区分析

江苏省自然科学基金资助项目江苏省扬州市社会发展项目&&

BK20191218YZ2021081BY20221106

2024

10.7619/jcmp.20241370

实用临床医药杂志
扬州大学,中国高校科技期刊研究会

实用临床医药杂志

CSTPCD
影响因子：1.543
ISSN：1672-2353
年,卷(期)：2024.28(17)