系统性炎症标志物在预测晚期上皮性卵巢癌新辅助铂反应和铂耐药中的预后价值：一项基于腹膜癌指数的分析

IF 4.5 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Gynecologic oncology Pub Date : 2025-07-09 DOI:10.1016/j.ygyno.2025.07.001

Onur Bektaş , Kıvılcım Bektaş

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引用次数: 0

摘要

目的通过腹膜癌指数（PCI）的降低率，评价治疗前全身炎症指数在预测晚期卵巢癌（AOC）患者对铂基新辅助化疗反应中的预后价值。此外，该研究试图评估这些标志物在识别可能产生铂耐药的患者中的预测能力。方法对FIGO iii - iv期上皮性卵巢癌患者进行新辅助化疗后间隔减容手术治疗前的全身炎症指标，包括中性粒细胞与淋巴细胞比值（NLR）、血小板与淋巴细胞比值（PLR）、单核细胞与淋巴细胞比值（MLR）和全身免疫炎症指数（SII）。分析这些标志物与治疗后PCI降低率之间的相关性。使用受试者工作特征（ROC）曲线分析评估这些标志物对铂耐药性的预测能力。结果治疗前全身炎症指标与PCI降低率呈显著正相关。较高的基线值，特别是SII，与PCI降低幅度较大相关，表明对化疗的反应更强。SII在预测铂电阻方面表现出最高的诊断准确性，曲线下面积（AUC）为0.790。NLR （>11.43）和SII （>2223.15）的最佳临界值对预测耐药具有良好的敏感性和特异性。结论全身炎症指标，尤其是SII，可能是AOC有价值的预测和预后的生物标志物。它们在治疗前评估中的使用可能有助于识别有化疗反应不良风险的患者，并指导个性化治疗策略，包括潜在的联合治疗需求，如贝伐单抗。

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Prognostic value of systemic inflammatory markers in predicting neoadjuvant platinum response and platinum resistance in advanced epithelial ovarian cancer: A peritoneal cancer index-based analysis

Objective

This study aimed to evaluate the prognostic value of pre-treatment systemic inflammatory indices in predicting the response to platinum-based neoadjuvant chemotherapy in patients with advanced ovarian cancer (AOC), as measured by the reduction rate of the Peritoneal Cancer Index (PCI). Additionally, the study sought to assess the predictive power of these markers in identifying patients likely to develop platinum resistance.

Methods

Systemic inflammatory markers including neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR) and systemic immune-inflammation index (SII) were recorded prior to treatment in patients diagnosed with FIGO stage IIIc-IV epithelial ovarian cancer who received neoadjuvant chemotherapy followed by interval debulking surgery. Correlations between these markers and post-treatment PCI reduction rates were analyzed. The predictive ability of these markers for platinum resistance was evaluated using receiver operating characteristic (ROC) curve analysis.

Results

Pre-treatment systemic inflammatory markers showed a statistically significant positive correlation with PCI reduction rate. Higher baseline values, particularly of SII, were associated with a greater PCI reduction, indicating a stronger response to chemotherapy. SII demonstrated the highest diagnostic accuracy for predicting platinum resistance, with an area under the curve (AUC) of 0.790. Optimal cut-off values for NLR (>11.43) and SII (>2223.15) were identified, showing good sensitivity and specificity for predicting resistance.

Conclusion

Systemic inflammatory indices, especially SII, appear to be valuable predictive and prognostic biomarkers in AOC. Their use in pre-treatment evaluation may help identify patients at risk of poor chemotherapy response and guide personalized treatment strategies, including the potential need for combination therapies such as bevacizumab.

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来源期刊

Gynecologic oncology 医学-妇产科学

CiteScore

8.60

自引率

6.40%

发文量

1062

审稿时长

37 days

期刊介绍： Gynecologic Oncology, an international journal, is devoted to the publication of clinical and investigative articles that concern tumors of the female reproductive tract. Investigations relating to the etiology, diagnosis, and treatment of female cancers, as well as research from any of the disciplines related to this field of interest, are published. Research Areas Include: • Cell and molecular biology • Chemotherapy • Cytology • Endocrinology • Epidemiology • Genetics • Gynecologic surgery • Immunology • Pathology • Radiotherapy