PLR NLR及CA199与免疫治疗晚期胃癌患者预后的关系研究

doi:10.3969/j.issn.1006-6233.2024.10.015

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Abstract Objective: To investigate the relationship between platelet-to-lymphocyte ratio (PLR), neutrophil-to-lymphocyte ratio (NLR), carbohydrate antigen 199 (CA199), and prognosis in advanced gastric cancer patients undergoing immune checkpoint inhibitor (ICI) therapy. Methods: A retrospective analysis was conducted on 103 advanced gastric cancer patients who received ICI treatment at our hospital from January 2022 to March 2024, with follow-up until June 2024. Pre-treatment PLR, NLR, and CA199 levels were collected. The ROC curves for these indicators were plotted against disease progression, and cutoff values were determined. Patients were divided into high and low PLR, NLR, and CA199 groups based on these values. Kaplan-Meier survival curves were plotted for each group, and the Cox proportional hazards regression model was used to analyze factors influencing the median progression-free survival (PFS) of these patients. Results: The ROC curve analysis identified cutoff values for PLR, NLR, and CA199 as 252.47, 3.39, and 43.63 U/mL, respectively. Based on these cutoff values, patients were divided into high PLR (n=58), low PLR (n=45), high NLR (n=50), low NLR (n=53), high CA199 (n=49), and low CA199 (n=54) groups. Kaplan-Meier analysis showed no statistically significant difference in PFS between the high PLR group (8.8 months) and the low PLR group (11.1 months) (P>0.05). However, the high NLR group (7.2 months) and high CA199 group (7.8 months) had significantly shorter PFS compared to the low NLR group (11.9 months) and low CA199 group (11.6 months) (P<0.05). Univariate Cox regression analysis showed that age ≥65 years, ECOG PS ≥1, high PLR, high NLR, and high CA199 were associated with shorter PFS in advanced gastric cancer patients undergoing ICI therapy (P<0.05). Multivariate Cox regression analysis identified ECOG PS ≥1, high NLR, and high CA199 as independent risk factors for PFS in these patients (P<0.05). Conclusion: Pre-treatment PLR, NLR, and CA199 levels are associated with the prognosis of advanced gastric cancer patients receiving ICI therapy, with NLR and CA199 being independent risk factors for PFS. Monitoring these indicators may provide clinical guidance for the treatment of advanced gastric cancer.

Key words： Platelet-to-lymphocyte ratio Neutrophil-to-lymphocyte ratio Carbohydrate antigen 199 Advanced gastric cancer Immunotherapy Prognosis

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http://www.hbyxzzs.cn/EN/10.3969/j.issn.1006-6233.2024.10.015 OR http://www.hbyxzzs.cn/EN/Y2024/V30/I10/1666

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