Value of Pan-immune-inflammation in Predicting Primary Resistance to Immunotherapy Combined with Chemotherapy in HER-2 Negative Advanced Gastric Cancer
Objective To investigate the value of pan-immune-inflammation value(PIV)in predicting primary resistance to immunotherapy combined with chemotherapy in patients with human epidermal growth factor receptor 2(HER-2)negative advanced gastric cancer.Methods A total of 62 patients with HER-2 negative advanced gastric cancer admitted to the First Affiliated Hospital of Bengbu Medical University from April 2020 to May 2024 were retrospectively analyzed.The first-line treatment was programmed cell death 1(PD-1)antibody combined with chemotherapy.Complete blood counts of advanced gastric cancer patients were collected within 1 week before treatment,PIV=[neutrophil count(109/L)×platelet count(109/L)× monocyte count(109/L)]/lymphocyte count(109/L).Patients with disease progression within 6 months were divided into the primary resistance group(n=19)and the remaining patients were divided into the control group(n=43).Baseline characteristics and PIV were compared between the primary resistance group and the control group.The predictive value of PIV for primary resistance was analyzed using receiver operating characteristic(ROC)curve.Patients were divided into high PIV group and low PIV group according to the optimal cut-off value of PIV,and the proportion of primary resistance between high PIV group and low PIV group was compared.Univariate and multivariate binary Logistic regression analyses were performed to identify factors that can affect primary resistance.Results The PIV was significantly higher in the resistant group than in the control group(P=0.021).The area under the curve(AUC)of PIV in predicting primary resistance to immunotherapy combined with chemotherapy was 0.725(P=0.005),with a sensitivity of 63.20％,specificity of 79.10％.The proportion of primary resistance in the high PIV group was higher than that in the low PIV group(57.14％vs 17.07％,P=0.001).Univariate binary regression Logistic analysis showed that PIV and peritoneal metastasis were risk factors for primary resistance(P=0.005,P=0.092).Multivariate binary Logistic analysis revealed that PIV was an independent predictive factor for primary resistance to immunotherapy combined with chemotherapy(P=0.007).Conclusion Baseline PIV is associated with primary resistance to immunotherapy combined chemotherapy in HER-2 negative advanced gastric cancer patients.PIV has certain predictive value for primary resistance to immunotherapy combined chemotherapy in HER-2 negative advanced gastric cancer patients.
NETL
NSTL
万方数据
