全身炎症免疫营养评分判断晚期胃癌免疫治疗预后的价值分析

doi:10.11904/j.issn.1002-3070.2025.01.006

摘要/Abstract

摘要： 目的本研究旨在探索全身-炎症-免疫-营养评分(systemic-inflammatory-immune-nutrition-score,SIINS)对晚期胃癌免疫治疗预后的预测价值。方法回顾性分析2018年10月—2022年7月于哈尔滨医科大学附属肿瘤医院接受程序性死亡受体1(programmed death-1,PD-1)抑制剂治疗的202例晚期胃癌患者临床资料。利用LASSO回归分析筛选有预后价值的指标,构建SIINS指标,利用受试者工作特征曲线确定SIINS指标预测预后的最佳截断值,并将患者分为高SIINS组和低SIINS组。采用单因素和多因素Cox回归分析确定总生存期(overall survival,OS)的独立预后因素。结果共筛选淋巴细胞计数,乳酸脱氢酶,中性粒细胞淋巴细胞4个指标用于构建SIINS指标,高SIINS组患者的预后显著低于低SIINS组(P＜0.05)。多因素Cox回归分析结果显示,美国东部肿瘤协作组(eastern cooperative oncology group,ECOG)评分、老年营养风险指数(geriatric nutritional risk index,GNRI)、SIINS、治疗方案以及治疗线数(P＜0.05)可作为晚期胃癌免疫治疗预后的独立预测因素。结论 SIINS可以预测晚期胃癌患者应用PD-1抑制剂的预后。

关键词: 胃癌, 免疫治疗, 预后, 全身-炎症-免疫-营养评分

Abstract: Objective The aim of this study was to explore the predictive value of the systemic inflammatory immune nutrition score(SIINS)for the prognosis of immunotherapy for advanced gastric cancer. Methods A retrospective analysis was conducted on the clinical data of 202 patients with advanced gastric cancer who received treatment with programmed death-1(PD-1)inhibitors at the Harbin Medical University Cancer Hospital from October 2018 to July 2022.The LASSO regression analysis was used to screen prognostic indicators,construct SIINS indicator,determine the optimal cutoff value for predicting prognosis using subject operating characteristic curves,and divide patients into the high SIINS and low SIINS groups.Independent prognostic factors for overall survival(OS)were determined using univariate and multivariate Cox regression analyses. Results Four indicators,including lymphocyte count,lactate dehydrogenase,and neutrophil lymphocytes,were selected to construct the SIINS index.The prognosis of patients in the high SIINS group was significantly lower than that in the low SIINS group(P＜0.05).The results of the multifactorial Cox regression analysis showed that the Eastern Cooperative Oncology Group(ECOG)score,Geriatric Nutritional Risk Index(GNRI),SIINS,treatment regimen,and number of treatment lines(P＜0.05)could serve as the independent predictive prognosis of immunotherapy for advanced gastric cancer. Conclusion SIINS can predict the prognosis of patients with advanced gastric cancer treated with PD-1 inhibitors.

Key words: Gastric cancer, Immunotherapy, Prognosis, Systemic-inflammatory-immune-nutritional-score

中图分类号:

R735.2

马铭, 王婉莹, 阮玉莉, 刘超, 张艳桥, 马志刚. 全身炎症免疫营养评分判断晚期胃癌免疫治疗预后的价值分析[J]. 实用肿瘤学杂志, 2025, 39(1): 39-48.

MA Ming, WANG Wanying, RUAN Yuli, LIU Chao, ZHANG Yanqiao, MA Zhigang. The values of systemic inflammatory immune nutritional score in predicting the prognosis of immunotherapy for advanced gastric cancer[J]. Journal of Practical Oncology, 2025, 39(1): 39-48.

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