山东大学学报 (医学版) ›› 2024, Vol. 62 ›› Issue (6): 48-53.doi: 10.6040/j.issn.1671-7554.0.2024.0267
• 临床医学 • 上一篇
田丽君1,桑玉洁1,孙瑜婧1,韩冰1,秦成勇2,祁建妮3
TIAN Lijun1, SANG Yujie1, SUN Yujing1, HAN Bing1, QIN Chengyong2, QI Jianni3
摘要： 目的 探讨全身免疫炎症指数(systemic-immune inflammation index, SII)对原发性肝癌(primary liver cancer, PLC)患者免疫检查点抑制剂(immune checkpoint inhibitors, ICIs)治疗相关不良反应的预测价值。 方法 选取2022年1月至2023年10月期间收治的接受ICIs治疗的162例PLC患者,按照是否发生免疫相关不良反应(immune-related adverse events, irAEs)分为irAEs组和非irAEs组。收集并比较两组的临床资料,采用多因素Logistic回归分析接受ICIs治疗的PLC患者发生irAEs的影响因素。绘制受试者工作特征(receiver operating characteristic, ROC)曲线评价SII对ICIs治疗后的PLC患者发生irAEs的预测价值。 结果 162例接受ICIs治疗的PLC患者中发生irAEs 77例(47.53%),其中单一性irAEs 74例,以内分泌毒性最常见(13.58%);多重性irAEs 3例,以肝脏毒性结合皮肤毒性最常见(1.23%)。多因素Logistic回归分析结果显示,既往自身免疫疾病史、IL-6、SII是影响接受ICIs治疗的PLC患者发生irAEs的独立危险因素(P<0.05)。ROC曲线分析结果显示:IL-6、SII预测接受ICIs治疗的PLC患者发生irAEs的曲线下面积分别为0.693(95%CI:0.589~0.797)、0.816(95%CI:0.732~0.900)。最佳截断值为1 336.8×109/L时,SII预测灵敏度和特异度分别为87.76%和63.65%。 结论 SII预测接受ICIs治疗的PLC患者发生irAEs具有良好价值,且是影响接受ICIs治疗的PLC患者发生irAEs的独立危险因素。
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