精准医学杂志 (Oct 2023)

VALUE OF A SCORING SYSTEM BASED ON INFLAMMATORY AND NUTRITIONAL INDICATORS IN PREDICTING THE EFFICACY OF NEOADJUVANT CHEMOTHERAPY FOR UPPER GASTRIC CANCER

  • ZHU Hongping, LIU Ruiqing, ZHANG Xianxiang, ZHANG Maoshen, WANG Dongsheng, LU Yun

DOI
https://doi.org/10.13362/j.jpmed.202305012
Journal volume & issue
Vol. 38, no. 5
pp. 427 – 430

Abstract

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Objective To investigate the association of inflammatory and nutritional indicators with the efficacy of neoadjuvant chemotherapy (NACT) in patients with upper gastric cancer before and after NACT, and to establish a clinical predictive model. Methods A total of 117 patients with upper gastric cancer who underwent NACT in Department of Gastroenterology in our hospital from April 2013 to January 2022 were enrolled, and according to the efficacy of chemotherapy, they were divided into effective group and ineffective group. Related clinical data were collected, such as age, sex, smoking history, drinking history, initial symptoms, tumor location, degree of tumor differentiation, tumor stage, tumor pathological type, and routine blood test results within one week before NACT and within one week after NACT. Univariate and multivariate analyses were performed to identify the influencing factors for the efficacy of NACT, and then a nomogram model was established and validated. Results The multivariate analysis showed that the difference in plasma neutrophil-to-lymphocyte ratio before and after NACT (△NLR) (OR=2.043,95%CI=1.334-3.127,P<0.05), the difference in plasma platelet-to-lymphocyte ratio before and after NACT (△PLR) (OR=1.007,95%CI=1.000-1.014,P<0.05), the difference in serum albumin before and after NACT (△Alb) (OR=0.936,95%CI=0.878-0.997,P<0.05), and T stage (OR=4.044,95%CI=1.128-14.501,P<0.05) were independent risk factors for the efficacy of NACT. A nomogram predictive model for the efficacy of NACT in upper gastric cancer was constructed based on the results of the multivariate analysis, with an area under the ROC curve of 0.877, and the calibration curve and the clinical decision curve showed that the model had good calibration and consistency with the actual results. Conclusion △NLR, △PLR, △Alb, and T stage are independent independent risk factors for the efficacy of NACT in patients with upper gastric can-cer, and the predictive model for the efficacy of NACT for upper gastric cancer has good predictive performance and clinical application value.

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