基线NLR和PLR对局部晚期头颈部鳞癌免疫治疗早期疗效的预测价值  

The predictive value of baseline NLR and PLR for early efficacy of immunotherapy in locally advanced head and neck squamous cell carcinoma

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作  者:张文颖[1] 袁海花[1] 胡晓华 王炯轶[1] 刘峰 ZHANG Wenying;HUAN Haihua;HU Xiaohua;WANG Jiongyi;LIU Feng(Department of Oncology,the Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,Shanghai 201999,China;Department of Oncology,Hainan Western Central Hospital,Hainan Danzhou 571831,China.)

机构地区:[1]上海交通大学医学院附属第九人民医院肿瘤科,上海201999 [2]海南西部中心医院肿瘤科,海南儋州571831

出  处:《现代肿瘤医学》2024年第19期3683-3688,共6页Journal of Modern Oncology

基  金:海南省自然科学基金项目(编号:824MS156)。

摘  要:目的:探讨基线NLR和PLR对接受免疫治疗的局部晚期头颈部鳞癌患者早期疗效的预测价值。方法:选取2021年01月至2022年12月在我院接受PD-1抑制剂联合化疗的局部晚期头颈部鳞癌患者52例,分析NLR、PLR和相关临床特征与免疫治疗早期疗效的相关性。利用ROC曲线获取NLR和PLR的最佳预测值,根据NLR和PLR最佳预测值将患者分为NLR和PLR高水平组与NLR和PLR低水平组,分析两组对早期治疗疗效的影响。结果:单因素分析发现疾病状态(P=0.002)、PD-L1表达(P=0.023)、NLR(P=0.011)和PLR(P=0.024)4个变量与早期治疗疗效显著相关。Logistic多因素回归分析,结果显示疾病状态(P=0.018)、NLR(P=0.009)和PLR(P=0.036)与早期治疗疗效显著相关。基线NLR<6.85和PLR<173.7患者的ORR明显高于NLR≥6.85和PLR≥173.7的患者(P=0.004和P=0.036)。结论:基线低NLR和PLR的局部晚期头颈部鳞癌患者更能从早期免疫治疗中获益。Objective:To explore the predictive value of baseline NLR and PLR for early efficacy in locally advanced head and neck squamous cell carcinoma(LA-HNSCC)patients receiving immunotherapy.Methods:This was a retrospective study of 52 patients with LA-HNSCC receiving PD-1 inhibitor combined with chemotherapy between January 2021 and December 2022.The combined impact of NLR,PLR and other clinical features was analyzed.The best cutoff values for NLR and PLR were derived using ROC curves.According to the best cutoff values of NLR and PLR,patients were divided into groups of high level NLR and PLR and groups of low level NLR and PLR.The impact of the two groups on early efficacy of neoadjuvant immunotherapy was analyzed.Results:In univariate analysis,disease status(P=0.002),PD-L1 expression(P=0.023),NLR(P=0.011)and PLR(P=0.024)were significantly associated with early efficacy of immunotherapy.Only disease status(P=0.018),NLR(P=0.009),and PLR(P=0.036)maintained a significant association with early efficacy of immunotherapy in multivariate analysis.Patients with baseline NLR<6.85 had significantly better efficacy than patients with NLR≥6.85(P=0.004),as did patients with baseline PLR<173.7 and PLR≥173.7(P=0.036).Conclusion:Low baseline NLR or PLR were associated with better immunotherapy efficacy in LA-HNSCC patients receiving immunotherapy.

关 键 词:头颈部鳞癌 中性粒细胞/淋巴细胞比值 血小板/淋巴细胞比值 免疫检查点抑制剂 

分 类 号:R730.261[医药卫生—肿瘤]

 

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