预后营养指数预测了Atezolizumab和Bevacizumab治疗的肝细胞癌的结果:一种倾向性得分匹配分析
Yuan-Hung Kuo1,2, Wei Teng2,3, Yen-Hao Chen2,4
1Division of Hepatology-Gastroenterology, Department of Internal Medicine, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Kaohsiung, Taiwan, China.
Journal of clinical and translational hepatology
|March 11, 2026
概括
预后营养指数 (PNI) 是晚期肝细胞癌 (HCC) 患者的生存的关键预测指标,这些患者接受了阿特佐利祖马布加贝瓦西祖马布 (Ate/Bev) 治疗. 较高的PNI得分与HCC患者的更好的结果和更少的副作用相关.
科学领域:
- 在瘤学瘤学.
- 免疫学 免疫学 免疫学
- 临床营养学 临床营养学
背景情况:
- 预后营养指数 (PNI) 评估免疫营养状况,是肝细胞癌 (HCC) 的潜在预后标志物.
- 在接受阿特佐利祖马布加贝瓦齐祖马布 (Ate/Bev) 治疗的高级HCC患者中,PNI的实用性尚未得到充分证实.
- 本研究调查了PNI在这个特定患者群体中的预后价值.
研究的目的:
- 评估先进HCC患者的PNI的预后意义,这些患者接受了第一线Ate/Bev治疗.
- 确定PNI是否可以预测治疗反应和生存结果.
- 评估PNI与与治疗相关的不良事件之间的关联.
主要方法:
- 对362名无法切除的HCC患者进行了回顾性分析,这些患者接受了Ate/Bev.治疗.
- 患者被分为低PNI (<45) 和高PNI (≥45) 的两组.
- 倾向性得分匹配被用来平衡基线特征,导致130名患者进行分析.
主要成果:
- 高PNI组表现出与治疗相关的3级以上不良事件的发生率明显较低 (10.8%与24.6%,p=0.039).
- 高PNI组的客观反应率更高 (38.4%对20.0%,p=0.037).
- 高PNI组的整体存活时间显著更长 (16.7 vs 7.9个月,p=0.009),PNI是生存的独立预测因素 (HR:0.574,p=0.025).
结论:
- 在接受Ate/Bev.的晚期HCC患者中,PNI作为整体生存的独立预后因素.
- 将PNI纳入常规临床评估可以改善这些患者的风险分层.
- PNI可能有助于指导高级HCC管理的治疗决策.
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