局部晚期食管癌新辅助化疗联合免疫治疗后病理完全应答的影响因素分析

Analysis of influencing factors of pathological complete response after neoadjuvant chemotherapy combined with immunotherapy for local advanced esophageal cancer

目的探讨局部进展期食管癌患者治疗前外周血淋巴细胞亚群及CT参数对新辅助免疫治疗联合化疗后疗效评估的预测价值。方法回顾性分析83例接受新辅助免疫联合化疗后行食管癌根治术患者的临床资料。收集患者治疗前外周血淋巴细胞亚群水平及CT上病灶长度、病灶厚度,进行单因素和多因素分析,评估病理完全缓解(p CR)的独立预测因素。结果共24例(28.9%)在新辅助免疫治疗联合化疗后达到p CR(p CR组)。p CR组的外周血CD4^(+)CD45RA-、CD4^(+)CD45RO^(+)百分比高于非p CR组,而非p CR组的CD45RA^(+)CD45RO^(+)百分比高于p CR组(均P<0.05)。多因素Logistic回归分析显示,外周血CD4^(+)CD45RO^(+)、CD45RA^(+)CD45RO^(+)百分比是影响食管癌患者新辅助免疫治疗联合化疗p CR的独立预测因素。结论外周血CD4^(+)CD45RO^(+)、CD45RA^(+)CD45RO^(+)可作为局部进展期食管癌患者新辅助免疫治疗联合化疗后pCR的预测因子。

Objective To investigate the predictive value of pretreatment peripheral blood lymphocyte subpopulation counts and CT parameters on the assessment of the efficacy of neoadjuvant immunotherapy combined with chemotherapy in patients with locally advanced esophageal squamous cell carcinoma(ESCC).Methods The clinical data of 83 patients who underwent radical esophageal cancer surgery after neoadjuvant immunotherapy combined with chemotherapy were retrospectively analyzed.The parameters of peripheral blood lymphocyte subpopulation counts,lesion length and thickness on CT images before treatment were collected,and univariate and multivariate analyses were performed to assess the independent predictors of pathological complete response(p CR).Results A total of 24 cases(28.9%)achieved p CR after neoadjuvant immunotherapy combined with chemotherapy(p CR group).p CR group had higher percentage of CD4^(+)CD45RAand CD4^(+)CD45RO^(+)in peripheral blood than non-pCR group,while non-pCR group had higher percentage of CD45RA^(+)CD45RO^(+)than pCR group(all P<0.05).Multivariate logistic regression analysis showed that peripheral blood CD4^(+)CD45RO^(+)and CD45RA^(+)CD45RO^(+)percentages were independent predictors of p CR in ESCC patients treated with neoadjuvant immunotherapy plus chemotherapy.Conclusions Peripheral blood CD4^(+)CD45RO^(+)and CD45RA^(+)CD45RO^(+)can be used as predictors of pCR after neoadjuvant immunotherapy plus chemotherapy in patients with locally advanced ESCC.