基于比率指数的诺米克图来预测免疫检查点抑制剂相关心肌炎的严重程度和预后:回顾性分析
Zhenli Li1, Tiezhu Yao1, Guang Liu1
1Department of Cardiology, The Fourth Hospital of Hebei Medical University, 12 Jiankang Road, Shijiazhuang, 050011, Hebei Provence, People's Republic of China.
Journal of cancer research and clinical oncology
|May 27, 2024
概括
像乳酸脱酶与蛋白比率 (LAR) 和中性粒细胞与高密度脂蛋白胆固醇比率 (NHR) 这样的比率生物标志物可以预测严重的免疫检查点抑制剂相关心肌炎 (ICI-M) 和主要不良心血管事件 (MACE). 纳入这些比率的nomogram模型为早期检测和监测提供了潜力.
科学领域:
- 在瘤学瘤学.
- 心脏病学 心脏病学
- 免疫学 免疫学 免疫学
背景情况:
- 免疫检查点抑制剂 (ICI) 可以引起与免疫相关的不良事件 (irAEs),包括心肌炎 (ICI-M).
- ICI-M是ICI治疗的罕见但可能致命的并发症.
- 需要预测ICI-M严重程度和预后的生物标志物.
研究的目的:
- 利用比率生物标志物开发基于名录的模型,以预测ICI-M的严重程度.
- 建立模型来预测ICI-M患者的主要不良心血管事件 (MACE).
- 评估特定比率指数的诊断和预后价值.
主要方法:
- 对被诊断为ICI-M的晚期癌症患者的回顾性分析.
- 将ICI-M患者分为轻度和重度组的分类.
- 开发和验证使用生物标志物,如乳酸脱酶与白蛋白比率 (LAR) 和中性粒细胞与高密度脂蛋白胆固醇比率 (NHR) 的诺米克模型.
- 进行40天的随访,以评估MACEs.
主要成果:
- 包括77名患者;40.3%的人患有严重的ICI-M.
- 结合LAR和其变化率 (ΔLAR) 的名图显示了严重ICI-M的良好诊断性能 (一致性指数:0.752).
- 结合NHR和LAR的诺米图预测了40天的MACE,其一致性指数为0.779.
- 在LAR中>101%的增加与无MACE生存率有显著的关联.
结论:
- 比例指数,包括LAR,NHR及其变化率,显示出ICI-M的显著诊断和预后价值.
- 基于这些比率指数的诺莫格拉姆模型可以帮助早期检测和监测严重的ICI-M和随后的MACE.
- 这些发现可能会改善接受ICI的患者的临床管理.
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