炎症标记物对结直肠癌术后转移患者抗PD-L1免疫治疗效果的预测作用分析  

Predictive effect of inflammatory markers on the efficacy of anti-PD-L1 immunotherapy in patients with postoperative metastasis of colorectal cancer

作　　者：董子瑜 汪超[1] DONG Ziyu;WANG Chao(Department of Oncology,Chaohu Hospital Affiliated to Anhui Medical University,Chaohu,Anhui,238000,China)

机构地区：[1]安徽医科大学附属巢湖医院肿瘤内科,安徽巢湖238000

出　　处：《中国中西医结合消化杂志》2023年第1期56-60,共5页Chinese Journal of Integrated Traditional and Western Medicine on Digestion

基　　金：安徽省卫生健康委科研项目(No:AHWJ2021b090)。

摘　　要：目的:探讨炎症标记物对结直肠癌术后转移患者抗PD-L1免疫治疗效果的预测作用。方法:回顾性分析2018年1月—2021年12月诊治的62例结直肠癌术后转移并接受抗PD-L1免疫治疗的患者的临床资料,分析中性粒细胞与淋巴细胞比值(NLR)、单核细胞与淋巴细胞比值(MLR)、血小板与淋巴细胞比值(PLR)与疾病客观缓解率(ORR)、疾病控制率(DCR)、无进展生存期(PFS)和免疫相关不良事件(irAEs)的相关性。结果:患者治疗后ORR组间比较差异无统计学意义。低MLR、NLR和PLR组患者3个月时DCR均高于高水平组患者(P<0.05)。共43例(69.35%)患者出现疾病进展,多变量分析表明MLR、NLR、PLR是疾病进展的相关因素。Kaplan-Meier曲线显示,MLR、NLR和PLR是PFS的独立预后因素。共有17例(27.42%)患者出现irAEs,低PLR组irAEs发生率明显高于高PLR组(P<0.05)。结论:外周血炎症标志物可以作为结直肠癌术后转移患者抗PD-L1治疗效果及预后的预测指标。Objective:To investigate the predictive effect of inflammatory markers on anti-PD-L1 immunotherapy in colorectal cancer patients with postoperative metastasis.Methods:From January 2018 to December 2021,62 patients with postoperative colorectal cancer metastasis who received anti-PD-L1 immunotherapy were retrospectively analyzed.Collect patient data and evaluate the correlation between neutrophil lymphocyte ratio(NLR),monocyte lymphocyte ratio(MLR),platelet lymphocyte ratio(PLR)and objective response rate(ORR),progression free survival(PFS),immune-related adverse events(irAEs).Results:There was no significant difference between ORR groups after treatment.The DCR of patients with low MLR,NLR and PLR at 3 months was higher than that of patients with high MLR(P<0.05).A total of 43 patients(69.35%)had disease progression.Multivariate analysis showed that MLR,NLR and PLR were related factors of disease progression.Kaplan-Meier curves showed that MLR,NLR and PLR were independent prognostic factors for PFS.A total of 17 patients(27.42%)had irAEs,and the incidence of irAEs in the low PLR group was significantly higher than that in the high PLR group(P<0.05).Conclusion:Peripheral blood inflammatory markers can be used as predictors of the efficacy and prognosis of anti-PD-L1 therapy in colorectal cancer patients with postoperative metastasis.

关 键 词：抗PD-L1治疗 炎症生物标志物 结直肠癌 手术 转移 

分 类 号：R735.34[医药卫生—肿瘤]