| Shaojie Xu,Yiming Feng,Xingyin Li,Zaozao Huang,Hewei Li,Ganxin Wang. Prognostic role of plasma levels of γ-glutamyl transpeptidase in patients with advanced gastric cancer treated with anti-PD-1 immunotherapy. Oncol Transl Med, 2022, 8: 109-153. |
| 接受抗PD-1免疫治疗的晚期胃癌患者血浆中的γ-谷氨酰转肽酶水平的预示作用 |
| Prognostic role of plasma levels of γ-glutamyl transpeptidase in patients with advanced gastric cancer treated with anti-PD-1 immunotherapy |
| Received:December 31, 2021 Revised:June 14, 2022 |
| DOI：10.1007/s10330-021-0547-7 |
| 中文关键词: 胃癌；程序性细胞死亡受体1；γ-谷氨酰转肽酶；预后 |
| 英文关键词: gastric cancer; programmed cell death receptor 1; γ-glutamyl transpeptidase (GGT); prognosis |
| 基金项目:本研究得到了湖北省和华中科技大学大学生创新创业训练计划（S202110487427, DYLC2021072）的支持。 |
| Author Name | Affiliation | E-mail | | Shaojie Xu | Huazhong University of Science and Technology | u201712199@hust.edu.cn | | Yiming Feng | Union Hospital, Tongji Medical College, Huazhong University of Science and Technology | | | Xingyin Li | Huazhong University of Science and Technology | | | Zaozao Huang* | Yangchunhu Community Hospital, Liyuan Hospital, Tongji Medical College, Huazhong University of Science and Technology | huangzaozao1986@163.com | | Hewei Li | Liyuan Hospital, Tongji Medical College, Huazhong University of Science and Technology | | | Ganxin Wang | Union Hospital, Tongji Medical College, Huazhong University of Science and Technology | |
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| 中文摘要: |
| 目的：
程序性细胞死亡蛋白1（PD-1）的抗体治疗已成为治疗高PDL-1水平的化疗难治性胃癌的主要手段。然而，由于缺乏可靠的检测方法，PDL-1检测在临床上的广泛应用受到限制。γ-谷氨酰转肽酶（GGT）是一种N端亲核水解酶。然而，血浆GGT水平作为抗PD-1治疗效果的独立预测因子的作用仍不清楚。在这项研究中，我们旨在发现血浆GGT水平变化（6周与基线相比）在接受抗PD-1免疫治疗的进展期胃癌患者预后中的作用。
方法：
本研究为回顾性研究，选取了2018年7月-2021年2月在武汉协和医院接受PD-1抗体（卡瑞利珠、达伯舒、欧狄沃、百泽安、拓益）治疗的胃癌患者57例
结果：
治疗6周后，疾病控制组（DC）和疾病进展组（PD）GGT 6周差值的差异有统计学差异（p<0.001）。多因素logistic回归分析显示，GGT 6周差值的连续值（OR=1.437, 95%CI=1.116-1.849, p=0.005）和GGT 6周差值≥0或<0（OR=53.675，95% CI=6.379-451.669, p=0.000）是疾病控制的独立预测因素。生存分析显示，治疗期间血浆GGT6水平的降低与良好的无进展生存率（PFS）和总生存率显著相关（p<0.001）。单变量和多变量Cox回归分析一致显示，治疗期间血浆GGT6水平下降是PFS的独立预测因子（HR=1.033,95%CI=1.013-1.053，p=0.001）。
结论：
在接受抗PD-1抗体治疗的晚期胃癌患者中，治疗期间血浆GGT水平的变化可作为疾病进展和生存率的预测指标。 |
| 英文摘要: |
| Objective Antibodies targeting programmed cell death protein 1 (PD-1) have become the mainstay of
treatment for chemotherapy-refractory gastric cancer, characterized by high levels of programmed cell
death ligand-1 (PDL-1) expression. However, the routine clinical implementation of PDL-1 testing is
currently limited by the lack of robust detection methods. In this regard, the role of plasma γ-glutamyl
transpeptidase (GGT), an N-terminal nucleophilic hydrolase, as an independent predictor of the efficacy of
anti-PD-1 therapy remains unknown. In this study, we aimed to assessed the prognostic role of changes in
plasma GGT levels (6 weeks vs. baseline) in patients with advanced gastric cancer treated with anti-PD-1
immunotherapy.
Methods We retrospectively analyzed data from 57 patients with gastric cancer treated with anti-PD-1
antibodies (camrelizumab, sintilimab, nivolumab, tislelizumab, and toripalimab) at the Union Hospital,
Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China, from July 2018
to February 2021.
Results We found that after 6 weeks of treatment, there were significant differences between responders
and non-responders with respect to plasma GGT levels (P < 0.001). Multivariate logistic regression analysis
revealed that the continuous value of the 6-week difference in GGT levels (OR = 1.437, 95% CI = 1.116–
1.849, P = 0.005) and 6-week difference in GGT ≥ 0 or < 0 (OR = 53.675, 95% CI = 6.379–451.669,
P < 0.001) were independent predictors of disease control. Survival analysis indicated that a reduction
in plasma GGT6 levels during treatment was significantly associated with a favorable progression-free
survival (PFS) and overall survival (P < 0.001). Consistently, univariate and multivariate Cox regression
analyses revealed that a reduction in plasma GGT6 levels during treatment was an independent predictor
of PFS (HR = 1.033, 95% CI = 1.013–1.053, P = 0.001).
Conclusion Alterations in plasma GGT levels during treatment can be used as a predictor of disease
progression and survival in patients with advanced gastric cancer undergoing treatment with anti-PD-1
antibodies. |
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