泛免疫炎症值对HER-2阴性晚期胃癌免疫联合化疗原发性耐药的预测  

Value of Pan-immune-inflammation in Predicting Primary Resistance to Immunotherapy Combined with Chemotherapy in HER-2 Negative Advanced Gastric Cancer

作　　者：汪婷婷 曾会会 胡婷 汪子书 WANG Tingting;ZENG Huihui;HU Ting;WANG Zishu(Department of Oncology,the First Affiliated Hospital of Bengbu Medical University,Bengbu 233000 China)

机构地区：[1]蚌埠医科大学第一附属医院肿瘤内科,安徽蚌埠233000

出　　处：《锦州医科大学学报》2024年第6期31-36,共6页Journal of Jinzhou Medical University

基　　金：安徽省高校自然科学研究项目,项目编号:2023AH052001;蚌埠医学院自然科学重点项目,项目编号:2022byzd035。

摘　　要：目的探讨泛免疫炎症值(pan-immune-inflammation value,PIV)对人表皮生长因子受体2(human epidermal growth factor receptor 2,HER-2)阴性晚期胃癌患者免疫联合化疗原发性耐药的预测价值。方法回顾性分析2020年4月至2024年5月蚌埠医科大学第一附属医院住院收治的62例HER-2阴性的晚期胃癌患者的临床资料,一线治疗采用程序性细胞死亡受体1(programmed cell death 1,PD-1)抗体联合化疗。收集晚期胃癌患者治疗前1周内的全血细胞计数,PIV=[中性粒细胞计数(10^(9)/L)×血小板计数(10^(9)/L)×单核细胞计数(10^(9)/L)]/淋巴细胞计数(10^(9)/L)。将6个月内出现疾病进展的患者分为原发性耐药组(n=19),其余患者为对照组(n=43)。比较原发性耐药组和对照组的基线特征和PIV。采用受试者工作特征(ROC)曲线分析PIV对原发性耐药的预测价值,依据PIV的最佳临界值将患者分为高PIV组和低PIV组,比较高PIV组和低PIV组发生原发性耐药的比例。单因素和多因素二元Logistic回归分析原发性耐药的影响因素。结果耐药组PIV明显高于对照组(P=0.021)。PIV预测免疫联合化疗原发性耐药的曲线下面积为0.725(P=0.005),敏感性63.20%,特异性79.10%。高PIV组胃癌患者发生原发性耐药的比例明显高于低PIV组(57.14%vs 17.07%,P=0.001)。单因素二元Logistic回归分析显示PIV、腹膜转移是原发性耐药的危险因素(P=0.005,P=0.092)。多因素二元Logistic回归分析显示PIV是晚期胃癌患者免疫联合化疗原发性耐药的独立预测因子(P=0.007)。结论基线PIV与HER-2阴性晚期胃癌患者免疫联合化疗原发性耐药有关,PIV对HER-2阴性晚期胃癌患者免疫联合化疗原发性耐药有一定的预测价值。Objective To investigate the value of pan-immune-inflammation value(PIV)in predicting primary resistance to immunotherapy combined with chemotherapy in patients with human epidermal growth factor receptor 2(HER-2)negative advanced gastric cancer.Methods A total of 62 patients with HER-2 negative advanced gastric cancer admitted to the First Affiliated Hospital of Bengbu Medical University from April 2020 to May 2024 were retrospectively analyzed.The first-line treatment was programmed cell death 1(PD-1)antibody combined with chemotherapy.Complete blood counts of advanced gastric cancer patients were collected within 1 week before treatment,PIV=[neutrophil count(10^(9)/L)×platelet count(10^(9)/L)×monocyte count(10^(9)/L)]/lymphocyte count(10^(9)/L).Patients with disease progression within 6 months were divided into the primary resistance group(n=19)and the remaining patients were divided into the control group(n=43).Baseline characteristics and PIV were compared between the primary resistance group and the control group.The predictive value of PIV for primary resistance was analyzed using receiver operating characteristic(ROC)curve.Patients were divided into high PIV group and low PIV group according to the optimal cut-off value of PIV,and the proportion of primary resistance between high PIV group and low PIV group was compared.Univariate and multivariate binary Logistic regression analyses were performed to identify factors that can affect primary resistance.Results The PIV was significantly higher in the resistant group than in the control group(P=0.021).The area under the curve(AUC)of PIV in predicting primary resistance to immunotherapy combined with chemotherapy was 0.725(P=0.005),with a sensitivity of 63.20%,specificity of 79.10%.The proportion of primary resistance in the high PIV group was higher than that in the low PIV group(57.14%vs 17.07%,P=0.001).Univariate binary regression Logistic analysis showed that PIV and peritoneal metastasis were risk factors for primary resistance(P=0.005,P=0.092).Multiva

关 键 词：泛免疫炎症值 胃恶性肿瘤 免疫治疗 原发性耐药 

分 类 号：R735[医药卫生—肿瘤]