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.
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。