炎症标志物及IGF-1在食管鳞癌新辅助免疫联合化疗疗效预测中的作用  

Inflammatory markers and IGF-1 in predicting the efficacy of neoadjuvant immunochemotherapy in esophageal squamous cell carcinoma

作　　者：王志鹏 陶慧鑫 蔡海波[3] 赵晓华 WANG Zhipeng;TAO Huixin;CAI Haibo;ZHAO Xiaohua(Department of Thoracic Surgery,Affiliated Hospital of Shandong Second Medical University,Weifang 261031,China;Department of Operating Room,Affiliated Hospital of Shandong Second Medical University;Department of Operating Room,First People's Hospital of Jining City)

机构地区：[1]山东第二医科大学附属医院胸外科,山东潍坊261031 [2]山东第二医科大学附属医院手术室 [3]济宁市第一人民医院胸外科

出　　处：《山东第二医科大学学报》2025年第1期33-37,共5页Journal of Shandong Second Medical University

基　　金：吴阶平医学基金会(项目编号:320.6750.2021-16-54);潍坊市科技发展计划项目(项目编号:2022YX090)。

摘　　要：目的 探索预测食管鳞癌(ESCC)患者行新辅助免疫联合化疗后疗效的生物标志物,为临床治疗提供参考。方法 采用观察法,纳入2022年12月~2024年6月在山东第二医科大学附属医院接受新辅助免疫联合化疗的90例局部晚期ESCC患者。免疫治疗前3d内检测血常规及IGF-1表达水平,计算中性粒细胞与淋巴细胞比值(NLR)及血小板与淋巴细胞比值(PLR),根据NLR、PLR、IGF-1截断值将患者分为高/低NLR组、高/低PLR组、高/低IGF-1组。采用实体瘤疗效评价标准1.1(RECIST 1.1)评估治疗2周期后的疗效。绘制NLR、PLR、IGF-1的ROC曲线,分析其与疗效之间的关系。比较ESCC组织与正常食管组织IGF-1的表达水平。结果 低NLR组和低PLR组疾病控制率(DCR)及客观缓解率(ORR)显著优于高NLR组和高PLR组(P<0.01)。IGF-1在ESCC组织中的表达高于正常食管组织(P<0.05),但高/低IGF-1组间的DCR及ORR无统计学差异(P>0.05),表明ESCC患者接受免疫治疗时,NLR和PLR的差异可能预示不同疗效。结论 低水平NLR和PLR能较好反映ESCC患者新辅助免疫联合化疗的疗效,敏感性和特异性良好,可能成为预测新辅助免疫联合化疗疗效的潜在生物标志物,为临床个体化治疗提供一种非侵入性、成本效益高的预测方法。Objective To explore potential biomarkers that predict the efficacy of neoadjuvant immunothera-py combined with chemotherapy in patients with esophageal squamous cell carcinoma(ESCC),providing reference for clinical treatment.Methods Observational study was conducted on 90 patients with locally advanced ESCC who re-ceived neoadjuvant immunotherapy combined with chemotherapy at the Affiliated Hospital of Shandong Second Medical University from December 2022 to June 2024.Blood routine tests and IGF-1 expression levels were measured within 3 days before immunotherapy.Neutrophil-to-lymphocyte ratio(NLR)and platelet-to-lymphocyte ratio(PLR)were calculat-ed.Patients were divided into high/low NLR,high/low PLR,and high/low IGF-1 groups based on cutoff values.Efficacy was assessed after two cycles of treatment using the Response Evaluation Criteria in Solid Tumors version 1.1(RECIST 1.1).ROC curves were drawn for NLR,PLR,and IGF-1 to analyze their relationship with efficacy.The expression levels of IGF-1 in ESCC tissues and normal esophageal tissues were compared.Results The disease control rate(DCR)and objective response rate(ORR)were significantly higher in the low NLR and low PLR groups compared with the high NLR and high PLR groups(P<0.01).IGF-1 expression was higher in ESCC tissues than in normal esophageal tissues(P<0.05),but there was no significant difference in DCR and ORR between the high and low IGF-1 groups(P>0.05).These findings suggest that differences in NLR and PLR may predict different treatment outcomes in ESCC patients re-ceiving immunotherapy.Conclusion Low levels of NLR and PLR can effectively reflect the efficacy of neoadjuvant im-munotherapy combined with chemotherapy in ESCC patients,with good sensitivity and specificity.They may serve as po-tential biomarkers for predicting treatment efficacy,offering a non-invasive and cost-effective predictive method for indi-vidualized clinical treatment.

关 键 词：食管肿瘤 外周血炎症相关指标 新辅助免疫联合化疗 IGF-1 

分 类 号：R735.1[医药卫生—肿瘤]