作者：吴衍章，王志雄，李广华，周志豪，王昭

单位：中山大学附属第一医院 胃肠外科中心，广东 广州 510080

Authors:  Wu Yanzhang, Wang Zhixiong, Li Guanghua, Zhou Zhihao, Wang Zhao

Unit:  Department of Gastroenterology Surgery, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, Guangdong, China

摘要：

目的 探讨炎症指标预测胃癌新辅助化疗敏感性的价值,以更好地筛查常规化疗方案不敏感的患者并确定最佳的个体化治疗策略。方法 回顾性分析144例接受SOX方案新辅助化疗的胃癌病例,根据实体瘤疗效评价标准1.1版对患者3个周期化疗前后的腹部CT影像进行化疗疗效评估,同时把患者分成临床缓解组(CR+PR)以及无缓解组(SD+PD),并比较两组患者的基线资料、免疫细胞、炎症指标等情况。结果 对所有病例的腹部CT影像进行化疗疗效评估后,总体病例的疾病控制率(DCR)为88.89%、临床缓解率(ORR)为36.11%。通过对临床指标以及炎症指标分析后发现淋巴细胞-单核细胞比值(LMR)在临床缓解组比无缓解组高[(2.94±2.38)比(2.37±0.84),P<0.05]。结论 对于接受SOX方案新辅助化疗的胃癌患者,更高的LMR提示有着更高的临床缓解率,但目前常规的临床以及炎症指标不能有效地预测新辅助化疗的临床缓解率。

关键词：胃癌; 新辅助化疗; 炎症指标; 化疗敏感性

Abstract：

Objective This study aimed to explore the clinical value of serum inflammation markers in predicting the chemosensitivity for gastric cancer, to screen the patients who are not sensitive to conventional chemotherapy. Methods We retrospectively reviewed data of 144 patients who accepted SOX for neoadjuvant chemotherapy with gastric cancer. According to the RECIST 1.1 version, the clinical response was evaluated by comparing the tumor size of abdominal CT between the initial and third chemotherapy. Patients were analyzed between clinical response group (CR+PR) and no response group (SD+PD). Results After evaluating the efficacy of chemotherapy on abdominal CT in all cases, the disease control rate(DCR) and overall response rate (ORR) were 88.89% and 36.11% respectively in this study. After analyzing the clinical characteristic and inflammation markers, it revealed that the lymphocyte-monocyte ratio (LMR) was significantly higher in the response group [(2.94±2.38) vs. (2.37±0.84) , P<0.05) ]. Conclusion For the gastric cancer patients who receiving SOX regimen neoadjuvant chemotherapy, LMR before adjuvant chemotherapy was related to better clinical response rate. However, there were no evidence revealed that the inflammation markers or other routine clinical characteristic were able to predicting the response rate effectively.

Key Words:  Gastric cancer; Neoadjuvant chemotherapy; Chemosensitivity; Inflammatory marker