Abstract：
OBJECTIVE: This study aimed to explore the value of D-dimer levels in predicting the treatment efficacy and prognosis of advanced esophageal squamous cell carcinoma (ESCC) treated with programmed cell death protein-1/programmed death-ligand 1 (PD-1/PD-L1) inhibitors.
METHODS: The study retrospectively analyzed 233 ESCC patients who received PD-1/PD-L1 inhibitors. The optimal cut-off values for platelets, fibrinogen, and D-dimer were calculated based on maximally selected rank statistics for patients\' overall survival. Univariate and multivariate analyses of progression-free survival and overall survival were conducted by Cox proportional hazards regression model. Subgroup analyses of D-dimer levels in different fibrinogen levels were performed by log-rank test.
RESULTS: The multivariate Cox regression analyses demonstrated that ESCC patients with D-dimer levels > 236 ng/mL exhibited both poorer progression-free survival (P = 0.004) and overall survival (P < 0.0001) compared to those with low D-dimer levels. The subgroup analyses further indicated that in the group of low fibrinogen levels, the higher D-dimer levels of ESCC patients exhibited significantly shorter progression-free survival (P = 0.0021) and overall survival (P < 0.0001).
CONCLUSIONS: The study revealed that the D-dimer levels possess predictive value for the treatment efficacy and prognosis of ESCC patients treated with PD-1/PD-L1 inhibitors.
METHODS: The study retrospectively analyzed 233 ESCC patients who received PD-1/PD-L1 inhibitors. The optimal cut-off values for platelets, fibrinogen, and D-dimer were calculated based on maximally selected rank statistics for patients\' overall survival. Univariate and multivariate analyses of progression-free survival and overall survival were conducted by Cox proportional hazards regression model. Subgroup analyses of D-dimer levels in different fibrinogen levels were performed by log-rank test.
RESULTS: The multivariate Cox regression analyses demonstrated that ESCC patients with D-dimer levels > 236 ng/mL exhibited both poorer progression-free survival (P = 0.004) and overall survival (P < 0.0001) compared to those with low D-dimer levels. The subgroup analyses further indicated that in the group of low fibrinogen levels, the higher D-dimer levels of ESCC patients exhibited significantly shorter progression-free survival (P = 0.0021) and overall survival (P < 0.0001).
CONCLUSIONS: The study revealed that the D-dimer levels possess predictive value for the treatment efficacy and prognosis of ESCC patients treated with PD-1/PD-L1 inhibitors.
摘要：
目的：本研究旨在探讨D-二聚体水平对程序性细胞死亡蛋白-1/程序性死亡配体1(PD-1/PD-L1)抑制剂治疗晚期食管鳞癌(ESCC)疗效及预后的预测价值。
方法：本研究回顾性分析了233例接受PD-1/PD-L1抑制剂的ESCC患者。血小板的最佳截止值，纤维蛋白原，和D-二聚体是根据患者总生存期的最大选择等级统计进行计算的。采用Cox比例风险回归模型对无进展生存期和总生存期进行单变量和多变量分析。采用对数秩检验对不同纤维蛋白原水平的D-二聚体进行亚组分析。
结果：多变量Cox回归分析表明，与D-二聚体水平低的患者相比，D-二聚体水平>236ng/mL的ESCC患者的无进展生存期（P=0.004）和总生存期（P<0.0001）均较差。亚组分析进一步表明，在低纤维蛋白原水平组中，ESCC患者的D-二聚体水平较高,其无进展生存期(P=0.0021)和总生存期(P<0.0001)明显较短.
结论：研究显示，D-二聚体水平对PD-1/PD-L1抑制剂治疗的ESCC患者的疗效和预后具有预测价值。
方法：本研究回顾性分析了233例接受PD-1/PD-L1抑制剂的ESCC患者。血小板的最佳截止值，纤维蛋白原，和D-二聚体是根据患者总生存期的最大选择等级统计进行计算的。采用Cox比例风险回归模型对无进展生存期和总生存期进行单变量和多变量分析。采用对数秩检验对不同纤维蛋白原水平的D-二聚体进行亚组分析。
结果：多变量Cox回归分析表明，与D-二聚体水平低的患者相比，D-二聚体水平>236ng/mL的ESCC患者的无进展生存期（P=0.004）和总生存期（P<0.0001）均较差。亚组分析进一步表明，在低纤维蛋白原水平组中，ESCC患者的D-二聚体水平较高,其无进展生存期(P=0.0021)和总生存期(P<0.0001)明显较短.
结论：研究显示，D-二聚体水平对PD-1/PD-L1抑制剂治疗的ESCC患者的疗效和预后具有预测价值。
