外周血细胞因子预测晚期胃癌抗PD-1治疗的疗效及预后  

Peripheral blood cytokines predict the efficacy and prognosis of anti-PD-1 therapy for advanced gastric cancer

作　　者：王馨焱 代虎威 刘晓玲[3] WANG Xinyan;DAI Huwei;LIU Xiaoling(The First Clinical Medical College of Shanxi Medical University,Shanxi Taiyuan 030001,China;The Second Clinical MedicalCollege of Shanxi Medical University,Shanxi Taiyuan 030001,China;Department of Special Medical,Shanxi Province CancerHospital,Shanxi Hospital Affiliated to Cancer Hospital,Chinese Academy of Medical Sciences,Cancer Hospital Affiliated to ShanxiMedical University,Shanxi Taiyuan 030013,China)

机构地区：[1]山西医科大学第一临床医学院,山西太原030001 [2]山西医科大学第二临床医学院,山西太原030001 [3]山西省肿瘤医院特需医疗部,中国医学科学院肿瘤医院山西医院,山西医科大学附属肿瘤医院,山西太原030013

出　　处：《现代肿瘤医学》2023年第15期2872-2878,共7页Journal of Modern Oncology

基　　金：吴阶平基金(编号:320.6750.2020-01-14)。

摘　　要：目的:探讨外周血白介素2、白介素4、白介素6、白介素10、白介素17A与晚期胃癌患者免疫治疗疗效及预后的关系。方法:收集2020年01月至2021年10月山西省肿瘤医院收治的88例应用免疫治疗的晚期胃癌患者临床病理资料及免疫治疗前外周血白介素2、白介素4、白介素6、白介素10、白介素17A的检测数据。用t检验分析影响患者细胞因子的因素。采用卡方检验分析不同组别间DCR和ORR的差异。采用Logistic回归法分析白介素6、白介素10与治疗效果的关系并绘制ROC曲线。采用Kaplan-Meier法绘制生存曲线,并用Log-rank检验生存曲线的差异。采用Cox风险比例模型分析白介素2、白介素4、白介素6、白介素10、白介素17A与无进展生存期之间的关系。结果:研究表明年龄、PD-L1水平、MMR状态在一定程度上会影响晚期胃癌患者的外周血细胞因子水平。在预后分析中,IL-6(HR=2.593,95%CI:1.470~4.572,P=0.001)、IL-10(HR=0.384,95%CI:0.197~0.747,P=0.005)、MMR状态(HR=0.103,95%CI:0.039~0.274,P<0.001)、PD-L1水平(HR=0.229,95%CI:0.106~0.497,P<0.001)是晚期胃癌患者免疫治疗PFS的独立预后因素。结论:外周血IL-6水平、IL-10水平可预测晚期胃癌患者免疫治疗的PFS,未来或许可作为生物标志物用于临床筛选免疫治疗获益患者。Objective:To investigate the relationship between peripheral blood cytokines(interleukin-2,interleukin-4,interleukin-6,interleukin-10,interleukin-17A)and the efficacy and prognosis of immunotherapy in advanced gastric cancer patients.Methods:The clinicopathological data of 88 patients with advanced gastric cancer admitted to Shanxi Province Cancer Hospital with immunotherapy and the detection data of interleukin-2,interleukin-4,interleukin-6,interleukin-10,interleukin-17A in peripheral blood before immunotherapy were collected from 01,2020 to 10,2021.Factors affecting cytokines in patients were analyzed by t-test.The differences in DCR and ORR between different groups were analyzed using chi-square test.Logistic regression was used to analyze the relationship between interleukin-6,interleukin-10 and treatment effect and to draw ROC curves.The Kaplan-Meier method was used to plot survival curves and the differences in survival curves were examined by Log-rank test.Cox risk proportional model was used to analyze the relationship between interleukin-2,interleukin-4,interleukin-6,interleukin-10,interleukin-17A and progression-free survival.Results:The study showed that age,PD-L1 level,and MMR status could affect the peripheral blood cytokine levels in patients with advanced gastric cancer to some extent.In the prognostic analysis,IL-6(HR=2.593,95%CI:1.470~4.572,P=0.001),IL-10(HR=0.384,95%CI:0.197~0.747,P=0.005),MMR status(HR=0.103,95%CI:0.039~0.274,P<0.001),PD-L1 expression(HR=0.229,95%CI:0.106~0.497,P<0.001)were independent predictors of immunotherapy PFS in patients with advanced gastric cancer.Conclusion:Peripheral IL-6 levels and IL-10 levels predict PFS of immunotherapy in patients with advanced gastric cancer.In the future,peripheral blood cytokines may be used as biomarkers for clinical screening of patients benefiting from immunotherapy.

关 键 词：晚期胃癌 生物标志物 细胞因子 免疫治疗 

分 类 号：R735.2[医药卫生—肿瘤]