Abstract：
BACKGROUND: Currently, immune checkpoint inhibitors (ICIs) have excellent performance in the clinical treatment of advanced gastric cancer (AGC). However, precisely selecting AGC patients who can benefit from immunotherapy is an urgent difficulty. In this study, we investigated the immunoprognostic role of myeloid-to-lymphocyte ratio (M:L) in AGC patients.
METHODS: We collected information on 268 AGC patients who were hospitalized in the Department of Medical Oncology of PLA General Hospital from December 2014 to May 2021. The patients were divided into low M: L group (< 3.76) and high M:L group (≥ 3.76). Survival differences between different M: L level groups at baseline and after treatment were analyzed by methods such as Kaplan-Meier, Cox or Logistic regression model.
RESULTS: Progression free survival (PFS) (5.8 months vs. 3.4 months, p = 0.001) and overall survival (OS) (14.1 months vs. 9.0 months, p = 0.001) were significantly longer in the low M:L group than in the high M:L group. After analyses of Cox regression modeling it was concluded that M:L was an independent prognostic factor for PFS (HR 1.371 95%CI 1.057-1.777 p = 0.017) and OS (HR 1.352 95%CI 1.003-1.824 p = 0.048), respectively. Subsequent subgroup analyses performed across immunotherapy lines, regimens, PD-1 inhibitor agents, and age groups revealed a poorer prognosis in the high M:L group. Notably, an increase in the value of M:L after treatment significantly increased the risk of poor prognosis.
CONCLUSIONS: M:L ≥ 3.76 is associated with poor prognostic outcomes in AGC patients receiving immunotherapy and may be a predictive biomarker of prognosis. This result needs to be confirmed by larger prospective studies.
METHODS: We collected information on 268 AGC patients who were hospitalized in the Department of Medical Oncology of PLA General Hospital from December 2014 to May 2021. The patients were divided into low M: L group (< 3.76) and high M:L group (≥ 3.76). Survival differences between different M: L level groups at baseline and after treatment were analyzed by methods such as Kaplan-Meier, Cox or Logistic regression model.
RESULTS: Progression free survival (PFS) (5.8 months vs. 3.4 months, p = 0.001) and overall survival (OS) (14.1 months vs. 9.0 months, p = 0.001) were significantly longer in the low M:L group than in the high M:L group. After analyses of Cox regression modeling it was concluded that M:L was an independent prognostic factor for PFS (HR 1.371 95%CI 1.057-1.777 p = 0.017) and OS (HR 1.352 95%CI 1.003-1.824 p = 0.048), respectively. Subsequent subgroup analyses performed across immunotherapy lines, regimens, PD-1 inhibitor agents, and age groups revealed a poorer prognosis in the high M:L group. Notably, an increase in the value of M:L after treatment significantly increased the risk of poor prognosis.
CONCLUSIONS: M:L ≥ 3.76 is associated with poor prognostic outcomes in AGC patients receiving immunotherapy and may be a predictive biomarker of prognosis. This result needs to be confirmed by larger prospective studies.
摘要：
背景：目前，免疫检查点抑制剂(ICIs)在晚期胃癌(AGC)的临床治疗中具有优异的性能。然而,准确选择能从免疫治疗中获益的AGC患者是一个紧迫的困难。在这项研究中,我们研究了髓样淋巴细胞比值(M:L)在AGC患者中的免疫预后作用.
方法：收集2014年12月至2021年5月解放军总医院肿瘤内科住院的268例AGC患者资料。将患者分为低M:L组(<3.76)和高M:L组(≥3.76)。采用Kaplan-Meier等方法分析不同M:L水平组治疗前后的生存差异,Cox或Logistic回归模型。
结果：无进展生存期（PFS）（5.8个月vs.3.4个月，p=0.001）和总生存期（OS）（14.1个月vs.9.0个月，p=0.001）在低M：L组中明显长于高M：L组。经过Cox回归模型分析，得出的结论是，M：L是PFS（HR1.37195CI1.057-1.777p=0.017）和OS（HR1.35295CI1.003-1.824p=0.048）的独立预后因素，分别。随后在免疫疗法线上进行的亚组分析，方案，PD-1抑制剂，和年龄组显示高M：L组预后较差。值得注意的是,治疗后M:L值的增加显著增加了不良预后的风险。
结论：M:L≥3.76与接受免疫治疗的AGC患者预后不良相关，可能是预后的预测生物标志物。这一结果需要更大规模的前瞻性研究来证实。
方法：收集2014年12月至2021年5月解放军总医院肿瘤内科住院的268例AGC患者资料。将患者分为低M:L组(<3.76)和高M:L组(≥3.76)。采用Kaplan-Meier等方法分析不同M:L水平组治疗前后的生存差异,Cox或Logistic回归模型。
结果：无进展生存期（PFS）（5.8个月vs.3.4个月，p=0.001）和总生存期（OS）（14.1个月vs.9.0个月，p=0.001）在低M：L组中明显长于高M：L组。经过Cox回归模型分析，得出的结论是，M：L是PFS（HR1.37195CI1.057-1.777p=0.017）和OS（HR1.35295CI1.003-1.824p=0.048）的独立预后因素，分别。随后在免疫疗法线上进行的亚组分析，方案，PD-1抑制剂，和年龄组显示高M：L组预后较差。值得注意的是,治疗后M:L值的增加显著增加了不良预后的风险。
结论：M:L≥3.76与接受免疫治疗的AGC患者预后不良相关，可能是预后的预测生物标志物。这一结果需要更大规模的前瞻性研究来证实。
