外周血生物标志物与免疫检查点抑制剂治疗晚期食管癌疗效的相关性

王培伟; 翁一鸣; 崔雪; 彭敏

doi:10.3971/j.issn.1000-8578.2023.22.0695

外周血生物标志物与免疫检查点抑制剂治疗晚期食管癌疗效的相关性

Correlation Between Peripheral Blood Biomarkers and Immune Checkpoint Inhibitors in Treatment of Advanced Esophageal Cancer

摘要

摘要:
目的探讨外周血标志物对于接受免疫检查点抑制剂（ICIs）治疗的晚期食管癌患者疗效和预后的影响。
方法收集61例满足纳入标准的晚期食管癌患者资料，包括临床指标、外周血标志物，观察其客观缓解率（ORR）和无进展生存期（PFS）。
结果纳入患者中位PFS为7.10个月（95%CI: 5.12~9.07）。基线乳酸脱氢酶（LDH） < 201患者的ORR优于LDH≥201患者（P < 0.05）。单因素分析显示基线LDH0 < 201、中性粒细胞淋巴细胞比值（NLR） < 3.9、血小板淋巴细胞比值（PLR） < 240.3及接受ICIs治疗后2周LDH1 < 249.0与PFS明显改善显著相关（P < 0.05）。多因素分析基线NLR0 < 3.9患者的PFS更长（P < 0.05）。
结论 LDH0 < 201、NLR0 < 3.9、PLR0 < 240.3、LDH1 < 249.0与接受ICIs治疗晚期食管癌患者的预后呈正相关。

Abstract:
Objective To explore the effect of peripheral blood markers on the efficacy and prognosis of patients with advanced esophageal cancer treated with immune checkpoint inhibitors (ICIs).
Methods The case data of 61 patients with advanced esophageal cancer who met the inclusion criteria were collected. Data on clinical indicators and peripheral blood markers as well as objective response rate (ORR) and progression-free-survival (PFS) were obtained.
Results The median PFS of the included patients was 7.10 months (95%CI: 5.12-9.07). The ORR of patients with baseline lactate dehydrogenase (LDH) < 201 was better than that of patients with LDH≥201 (P < 0.05). Univariate analysis showed that baseline LDH0 < 201, neutrophil to lymphocyte ratio (NLR) < 3.9, platelet-to-lymphocyte ratio (PLR) < 240.3, and LDH1 < 249.0 two weeks after ICI treatment were significantly associated with significant improvement in PFS (P < 0.05). In multivariate analysis, patients with NLR0 < 3.9 had longer PFS (P < 0.05).
Conclusion LDH0 < 201, NLR0 < 3.9, PLR0 < 240.3, and LDH1 < 249.0 are positively correlated with the prognosis of patients with advanced esophageal cancer treated with ICIs.

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