NLR对局晚期口腔鳞状细胞癌患者术前尼妥珠单抗联合新辅助化疗疗效预测价值研究

田亮亮; 南欣荣

doi:10.12016/j.issn.2096-1456.2024.05.005

口腔疾病防治 ›› 2024, Vol. 32 ›› Issue (5) : 359 -366. DOI: 10.12016/j.issn.2096-1456.2024.05.005

临床研究

NLR对局晚期口腔鳞状细胞癌患者术前尼妥珠单抗联合新辅助化疗疗效预测价值研究

田亮亮, 南欣荣

作者信息 +

The value of NLR in predicting the efficacy of preoperative nimotuzumab combined with neoadjuvant chemotherapy for local advanced oral squamous cell carcinoma

Author information +

文章历史 +

PDF (37657K)

摘要

目的探讨尼妥珠单抗联合新辅助化疗前外周血中性粒细胞和淋巴细胞比值（neutrophil to lymphocyte ratio，NLR）对局晚期口腔鳞状细胞癌（oral squamous cell carcinoma，OSCC）患者术前新辅助治疗近期疗效的预测价值，为临床提供参考。方法本研究获得伦理委员会审批和患者知情同意，收集2020年9月至2023年6月就诊于山西医科大学第一医院口腔颌面外科的Ⅲ、Ⅳ期OSCC患者59例，所有患者临床资料完整，都经病理学确诊为鳞状细胞癌，并接受术前尼妥珠单抗+TP（多西他赛+顺铂）新辅助化疗；分析其临床资料，收集治疗前及治疗后外周血中性粒细胞数值、淋巴细胞数值；计算比值NLR，使用受试者工作特征曲线（receiver operating characteristic curve，ROC）计算得到阈值，根据尼妥珠单抗联合TP新辅助化疗前NLR阈值将患者分为高NLR组和低NLR组；根据实体瘤疗效评价标准评估尼妥珠单抗联合TP新辅助化疗后临床疗效，分析NLR与近期疗效的相关性；使用免疫组织化学染色方法检测尼妥珠单抗联合TP新辅助化疗前后OSCC组织中表皮生长因子受体（epidermal growth factor receptor，EGFR）的表达，分析不同NLR组间EGFR表达差异。结果共收集59 例晚期OSCC患者，根据ROC曲线得到NLR阈值为2.377，将患者分为<2.377组（低NLR组）24例，>2.377组（高NLR组）35例；低NLR组较高NLR组近期疗效好（P<0.05）；低NLR组和高NLR组治疗后EGFR表达均下降，低NLR组较高NLR组下降幅度更大，差异有统计学意义（P<0.05）。结论尼妥珠单抗联合TP新辅助化疗前低NLR的患者有较好的疗效，此类患者更有可能在术前尼妥珠单抗联合新辅助化疗中受益。

Abstract

Objective To investigate the value of the peripheral blood neutrophil to lymphocyte ratio (NLR) before nimotuzumab combined with neoadjuvant chemotherapy in predicting the short-term efficacy of neoadjuvant therapy for advanced oral squamous cell carcinoma (OSCC). Methods With the approval of the Ethics Committee and the informed consent of the patients, 59 patients with stage Ⅲ and Ⅳ OSCC who were admitted to the Oral and Maxillofacial Surgery Department of the First Hospital of Shanxi Medical University from September 2020 to June 2023 were enrolled. All the patients had complete clinical data, were pathologically diagnosed with squamous cell carcinoma, and received preoperative and received preoperative nimotuzumab + TP (docetaxel + cisplatin) neoadjuvant chemotherapy. The clinical data were analyzed, and the neutrophil and lymphocyte counts in peripheral blood were collected before and after nimotuzumab combined with neoadjuvant chemotherapy. The NLR was calculated, and the threshold value was calculated using the receiver operating characteristic (ROC) curve. Patients were divided into a high NLR group and a low NLR group according to the NLR threshold before nimotuzumab combined with neoadjuvant chemotherapy with TP. The clinical efficacy after nimotuzumab combined with neoadjuvant chemotherapy with TP was evaluated according to the evaluation criteria for solid tumor efficacy, and the correlation between the NLR and recent neoadjuvant therapy efficacy was analyzed. Immunohistochemical staining was used to detect the expression of epidermal growth factor receptor (EGFR) in OSCC tissues before and after nimotuzumab combined with neoadjuvant chemotherapy with TP and to analyze whether the expression of EGFR differed among the different NLR groups. Results A total of 59 patients with advanced OSCC were included. According to the ROC curve, the NLR threshold was 2.377, and the patients were divided into a <2.377 group (low NLR group), with 24 patients, and a>2.377 group (high NLR group), with 35 patients. The short-term neoadjuvant therapy effect was significantly greater in the lower NLR group than in the higher NLR group (P<0.05); EGFR expression in both the low NLR group and the high NLR group decreased after nimotuzumab combined with neoadjuvant chemotherapy with TP, and the decrease in the low NLR group was significantly greater than that in the high NLR group (P<0.05). Conclusion A low NLR before nimotuzumab combined with neoadjuvant chemotherapy with TP is associated with better neoadjuvant therapy outcomes, and such patients are more likely to benefit from preoperative nimotuzumab combined with neoadjuvant chemotherapy.