Abstract:
The pan-immune-inflammation-value (PIV) is a comprehensive biomarker that integrates different peripheral blood cell subsets. The present study aimed to evaluate the prognostic ability of PIV in patients with nasopharyngeal carcinoma (NPC) undergoing chemoradiotherapy. PIV was assessed using the following equation: (Neutrophil count × platelet count × monocyte count)/lymphocyte count. The Kaplan-Meier method and Cox hazards regression models were used for survival analyses. The optimal cut-off values for PIV and systemic immune-inflammation index (SII) were determined using receiver operating characteristic analysis to be 428.0 and 1032.7, respectively. A total of 319 patients were recruited. Patients with a low baseline PIV (≤428.0) accounted for 69.9% (n=223) and patients with a high baseline PIV (>428.0) accounted for 30.1% (n=96). Compared with patients with low PIV, patients with a high PIV had significantly worse 5-year progression-free survival [PFS; 66.8 vs. 77.1%; hazard ratio (HR), 1.97; 95% confidence interval (CI), 1.22-3.23); P=0.005] and 5-year overall survival (OS; 68.7 vs. 86.9%, HR, 2.71; 95% CI, 1.45-5.03; P=0.001). PIV was also a significant independent prognostic indicator for OS (HR, 2.19; 95% CI, 1.16-4.12; P=0.016) and PFS (HR, 1.86; 95% CI, 1.14-3.04; P=0.013) and outperformed the SII in multivariate analysis. In conclusion, the PIV was a powerful predictor of survival outcomes and outperformed the SII in patients with NPC treated with chemoradiotherapy. Prospective validation of the PIV should be performed to better stratify radical treatment of patients with NPC.
摘要:
泛免疫炎症值(PIV)是整合不同外周血细胞亚群的综合生物标志物。本研究旨在评估接受放化疗的鼻咽癌(NPC)患者的PIV预后能力。使用以下等式评估PIV:(中性粒细胞计数×血小板计数×单核细胞计数)/淋巴细胞计数。使用Kaplan-Meier方法和Cox风险回归模型进行生存分析。使用受试者工作特征分析确定PIV和全身免疫炎症指数(SII)的最佳临界值分别为428.0和1032.7。共招募了319名患者。低基线PIV患者(≤428.0)占69.9%(n=223),高基线PIV患者(>428.0)占30.1%(n=96)。与低PIV患者相比,高PIV患者的5年无进展生存期显著恶化[PFS;66.8vs.77.1%;危险比(HR),1.97;95%置信区间(CI),1.22-3.23);P=0.005]和5年总生存率(OS;68.7vs.86.9%,HR,2.71;95%CI,1.45-5.03;P=0.001)。PIV也是OS的重要独立预后指标(HR,2.19;95%CI,1.16-4.12;P=0.016)和PFS(HR,1.86;95%CI,1.14-3.04;P=0.013),在多变量分析中优于SII。总之,在接受放化疗的NPC患者中,PIV是生存结局的有力预测因子,优于SII.应进行PIV的前瞻性验证,以更好地对NPC患者的根治性治疗进行分层。