Evaluation value of CONUT score,PAR and MPVLR before treatment on immunotherapy efficacy and immune-related adverse reactions in advanced gastric cancer patients
10.3969/j.issn.1673-4130.2025.11.013
- VernacularTitle:治疗前CONUT评分、PAR及MPVLR对进展期胃癌患者免疫治疗效果及免疫相关不良反应的评估价值
- Author:
Pengfei YANG
1
;
Zhimin WEI
;
Chongxin ZHANG
;
Jie YANG
;
Wei PENG
;
Fan ZHANG
Author Information
1. 湘西土家族苗族自治州人民医院/吉首大学第一附属医院普外科,湖南吉首 416000
- Keywords:
advanced gastric cancer;
immunotherapy;
immune-related adverse reactions;
nutritional status control score;
platelet to albumin ratio;
mean platelet volume to lymphocyte ratio
- From:
International Journal of Laboratory Medicine
2025;46(11):1347-1352
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the value of nutritional status control(CONUT)score,platelet to albumin ratio(PAR)and mean platelet volume to lymphocyte ratio(MPVLR)before treatment on immunotherapy efficacy and immune-related adverse reactions(irAEs)in advanced gastric cancer patients.Methods A total of 113 patients with advanced gastric cancer admitted to the hospital from January 2020 to June 2023 were selected as the gas-tric cancer group,and 113 healthy volunteers were selected as the control group.According to the efficacy of immunotherapy,the patients with advanced gastric cancer were divided into effective group(70 cases)and in-effective group(43 cases),and divided into irAEs group(51 cases)and non-irAEs group(62 cases)according to whether irAEs occurred.The factors influencing the occurrence of irAEs in advanced gastric cancer were analyzed,and the value of CONUT score,PAR and MPVLR before treatment in predicting the efficacy of im-munotherapy and irAEs in advanced gastric cancer was analyzed.Results The CONUT score,PAR and MPV-LR in gastric cancer group before treatment were higher than those in control group(P＜0.05).The CONUT score,PAR and MPVLR before treatment in the ineffective group were higher than those in the effective group(P＜0.05).The area under the curve(AUC)of CONUT score,PAR and MPVLR alone in predicting the ineffective immunotherapy in advanced gastric cancer patients before treatment were 0.779,0.739 and 0.766,respectively,the AUC predicted by combined detection was 0.889,which was higher than that predic-ted by alone(P＜0.05).The CONUT score,PAR and MPVLR before treatment in irAEs group were higher than those in non-irAEs group(P＜0.05).The age of irAEs group was lower than that of non-irAEs group(P＜0.05),and the proportion of Ki-67 index,CD4+T lymphocytes and Treg cells was lower than that of non-irAEs group(P＜0.05).The increase of CONUT score,PAR and MPVLR before treatment were risk factors for irAEs in advanced gastric cancer patients(P＜0.05),and the increase of Treg cell proportion was a protective factor(P＜0.05).The AUC of CONUT score,PAR and MPVLR alone in predicting the occurrence of irAEs in advanced gastric cancer patients before treatment was 0.816,0.798 and 0.783,respectively,the AUC predic-ted by combined detection was 0.887,which was higher than that predicted alone(P＜0.05).Conclusion The CO-NUT score,PAR and MPVLR before treatment are significantly increased in advanced gastric cancer patients,and are associated with ineffective immunotherapy and the occurrence of irAEs.The combined detection of the three indicators can effectively predict the immunotherapy efficacy and irAEs in advanced gastric cancer pa-tients.
