PDF(Pubmed)
Abstract：
BACKGROUND: Gastric cancer with only peritoneal lavage cytology (GC-CY1) is a special type of gastric cancer, which is defined as stage IV. The pre-treatment systemic immune-inflammation index (SII) and prognostic nutritional index (PNI) are representative blood indexes of systemic inflammatory response and nutritional status. However, the clinical significance of combined detection of these two indexes is still unclear. This study aims to evaluate the clinical value of the new score system by combining SII and PNI (SII-PNI score) as a predictor of efficacy and prognosis after neoadjuvant intraperitoneal and systemic (NIPS) paclitaxel combined with Apatinib conversion therapy for GC-CY1 patients.
METHODS: We registered a prospective clinical study involving 36 GC-CY1 patients from April 2018 to August 2019 (NCT03718624). All patients underwent re-laparoscopic exploration after treatment. According to free cancer cells (FCCs) status, these patients were divided into FCCs group and non-FCCs group. The SII-PNI score ranged from 0 to 2 as follows: score of 2, high SII (≥512.1) and low PNI (≤52.9); score of 1, either high SII or low PNI; score of 0, no high SII nor low PNI.
RESULTS: All patients underwent re-laparoscopic exploration after 3 cycles of NIPS paclitaxel and Apatinib conversion therapy. Among them, 28 cases (77.78%) were in non-FCCs group, and 8 cases (22.22%) were in FCCs group. The SII-PNI score of non-FCCs patients was significantly lower than that of FCCs patients (p=0.041). The prognosis of patients with high SII-PNI score was significantly worse than that of patients with low SII-PNI score (p<0.001). Multivariate analysis showed that SII-PNI score was an independent prognostic factor for predicting overall survival and progression-free survival (p=0.001, 0.002).
CONCLUSIONS: Pretreatment SII-PNI score is an important predictor for the efficacy of GC-CY1 patients after NIPS paclitaxel combined with Apatinib conversion therapy, which can help to identify high-risk groups and predict prognosis.
METHODS: We registered a prospective clinical study involving 36 GC-CY1 patients from April 2018 to August 2019 (NCT03718624). All patients underwent re-laparoscopic exploration after treatment. According to free cancer cells (FCCs) status, these patients were divided into FCCs group and non-FCCs group. The SII-PNI score ranged from 0 to 2 as follows: score of 2, high SII (≥512.1) and low PNI (≤52.9); score of 1, either high SII or low PNI; score of 0, no high SII nor low PNI.
RESULTS: All patients underwent re-laparoscopic exploration after 3 cycles of NIPS paclitaxel and Apatinib conversion therapy. Among them, 28 cases (77.78%) were in non-FCCs group, and 8 cases (22.22%) were in FCCs group. The SII-PNI score of non-FCCs patients was significantly lower than that of FCCs patients (p=0.041). The prognosis of patients with high SII-PNI score was significantly worse than that of patients with low SII-PNI score (p<0.001). Multivariate analysis showed that SII-PNI score was an independent prognostic factor for predicting overall survival and progression-free survival (p=0.001, 0.002).
CONCLUSIONS: Pretreatment SII-PNI score is an important predictor for the efficacy of GC-CY1 patients after NIPS paclitaxel combined with Apatinib conversion therapy, which can help to identify high-risk groups and predict prognosis.
摘要：
背景：仅进行腹膜灌洗细胞学（GC-CY1）的胃癌是一种特殊类型的胃癌，定义为第四阶段。治疗前全身免疫炎症指数（SII）和预后营养指数（PNI）是全身炎症反应和营养状况的代表性血液指标。然而,这两个指标联合检测的临床意义尚不清楚。本研究旨在通过联合SII和PNI（SII-PNI评分）作为新辅助腹膜内和全身（NIPS）紫杉醇联合阿帕替尼转换治疗GC-CY1患者后疗效和预后的预测指标，评估新评分系统的临床价值。
方法：我们注册了一项前瞻性临床研究，纳入了2018年4月至2019年8月的36例GC-CY1患者（NCT03718624）。所有患者治疗后均行再次腹腔镜探查术。根据游离癌细胞（FCC）的状态，将这些患者分为FCCs组和非FCCs组.SII-PNI得分为0至2分，分为2分，高SII（≥512.1）和低PNI（≤52.9）；1分，高SII或低PNI；0分，无高SII或低PNI。
结果：所有患者在接受3个周期的NIPS紫杉醇和阿帕替尼转换治疗后再次行腹腔镜探查。其中,非FCCs组28例(77.78%),FCCs组8例(22.22%)。非FCCs患者的SII-PNI评分明显低于FCCs患者(p=0.041)。SII-PNI评分高的患者预后显著差于SII-PNI评分低的患者(p<0.001)。多因素分析显示，SII-PNI评分是预测总生存期和无进展生存期的独立预后因素（p=0.001，0.002）。
结论：治疗前SII-PNI评分是NIPS紫杉醇联合阿帕替尼转换治疗后GC-CY1患者疗效的重要预测因子，这有助于识别高危人群和预测预后。
方法：我们注册了一项前瞻性临床研究，纳入了2018年4月至2019年8月的36例GC-CY1患者（NCT03718624）。所有患者治疗后均行再次腹腔镜探查术。根据游离癌细胞（FCC）的状态，将这些患者分为FCCs组和非FCCs组.SII-PNI得分为0至2分，分为2分，高SII（≥512.1）和低PNI（≤52.9）；1分，高SII或低PNI；0分，无高SII或低PNI。
结果：所有患者在接受3个周期的NIPS紫杉醇和阿帕替尼转换治疗后再次行腹腔镜探查。其中,非FCCs组28例(77.78%),FCCs组8例(22.22%)。非FCCs患者的SII-PNI评分明显低于FCCs患者(p=0.041)。SII-PNI评分高的患者预后显著差于SII-PNI评分低的患者(p<0.001)。多因素分析显示，SII-PNI评分是预测总生存期和无进展生存期的独立预后因素（p=0.001，0.002）。
结论：治疗前SII-PNI评分是NIPS紫杉醇联合阿帕替尼转换治疗后GC-CY1患者疗效的重要预测因子，这有助于识别高危人群和预测预后。
