摘要
目的分析肿瘤免疫治疗对微卫星稳定(MSS)型Ⅳ期结直肠癌患者预后的影响。方法分析2018年6月-2022年12月就诊于中山大学附属第七医院,经病理确诊为MSS型Ⅳ期的152例结直肠癌患者的临床病理资料,按纳入与排除标准,根据是否接受肿瘤免疫治疗分为免疫治疗组(n=42)和非免疫治疗组(n=110)。建立基线特征表,并使用倾向性评分匹配(PSM)筛选出两组基线特征一致的患者,比较其预后情况。结果PSM筛选后免疫治疗组42例,非免疫治疗组65例,中位随访时间为31.1个月。免疫治疗分组患者的生存时间进行Log Rank秩和检验,差异有统计学意义(HR=0.518,P=0.029)。对数据行多因素COX回归分析,年龄(β=0.775,HR=2.170,P=0.041)、手术(β=-1.137,HR=0.321,P=0.005)以及免疫治疗(β=-0.805,HR=0.447,P=0.023)是晚期(Ⅳ期)结直肠癌患者总生存期的独立风险因素。结论免疫治疗可延长MSS型晚期结直肠癌患者总生存期,提示此类患者能够从免疫治疗中获益。
Objective To analyze the effect of tumor immunotherapy on the prognosis of patients with microsatellite stability(MSS)stage Ⅳ colorectal cancer.Methods A retrospective study was conducted on the clinical data of 152 patients who were pathologically diagnosed with MSS type stage Ⅳ colorectal cancer from June 2018 to December 2022 in the Seventh Affiliated Hospital of Sun Yat-sen University.According to whether they had received tumor immunotherapy,patients were divided into immunotherapy group(n=42)and non-immunotherapy group(n=110).A baseline table of characteristics was created by clinical data of all patients.Propensity score matching(PSM)was used to create 2 groups of patients which had the same baseline characteristic,and then compared their prognosis.Results There were 42 patients in the immunotherapy group and 65 patients in the non-immunotherapy group after PSM;the median follow-up was 31.1 months.Log Rank sum test(HR=0.518,P=0.029)showed significant difference in overall survival of patients in immunotherapy group.Multivariate COX regression analysis was performed after PSM.Age(≥65 years old)(β=0.775,HR=2.170,P=0.041),surgery(β=-1.137,HR=0.321,P=0.005),and immunotherapy(β=-0.805,HR=0.447,P=0.023)were independent risk factors for overall survival in patients with advanced(stage Ⅳ)colorectal cancer.Conclusion The overall survival of patients with MSS type advanced colorectal cancer was significantly prolonged by immunotherapy,suggesting that these patients were benefited from immunotherapy.
作者
陈紫玉
董海峰
张华
王小群
陈鸿
王康
刘馨然
何裕隆
张常华
CHEN Ziyu;DONG Haifeng;ZHANG Hua;WANG Xiaoqun;CHEN Hong;WANG Kang;LIU Xinran;HE Yulong;ZHANG Changhua(Digestive Diseases Center,the Seventh Affiliated Hospital of Sun Yat-sen University,Shenzhen,Guangdong 518107,China;Guangdong Provincial Key Laboratory of Digestive Cancer Research,the Seventh Affiliated Hospital of Sun Yat-sen University,Shenzhen,Guangdong 518107,China)
出处
《热带医学杂志》
CAS
2023年第5期628-632,共5页
Journal of Tropical Medicine
基金
广东省消化系统恶性肿瘤防治研究重点实验室开放基金(2021B1212040006)
深圳市“医疗卫生三名工程”资助项目(SZSM201911010)
深圳市医学重点学科建设基金(SZXK016)
深圳市可持续发展科技专项(KCXFZ20200201101059392)
深圳市深港澳科技计划(C类)协同创新专项(SGDX20201103092601008)
中山七院临床兼职PI起步基金(ZSQYJZPI202001)
关键词
微卫星稳定型
结直肠癌
免疫治疗
倾向性评分匹配
Microsatellite stability stage
Colorectal cancer
Immunotherapy
Propensity score matching
作者简介
陈紫玉(1996-),男,在读硕士研究生,研究方向为结直肠癌的临床诊疗;共同第一作者:董海峰;通信作者:张常华,E-mail:zhangchanghua@sysush.com
