Introduction The kinetic of C-reactive protein (CRP) in the early phase of therapy with checkpoint inhibitors (CPI) and its prognostic value has already been investigated in several tumor entities. In particular, flare dynamics have been described as a positive prognostic parameter. The aim of this retrospective study is to examine the extent to which such an application can also be transferred to patients with recurrent or metastatic squamous cell carcinoma of the head and neck region (R/M-HNSCC). Material and Methods All patients treated with CPI for R/M-HNSCC at our clinic between 2018 and 2023 were included (n= 44). Demographic, clinical, histopathologic and laboratory data were extracted from the digital patient records and statistically analyzed. We then examined the CRP kinetic using two previously published classifications and proposed a new classification ourselves. Subsequently, correlation analyses were performed with the overall survival (OS) of the patients. Results Of the two CRP kinetic classifications previously published, only one showed a correlation with the result of the first re-staging, and neither showed a correlation with the OS of R/M-HNSCC patients. Our new CRP kinetic classification showed a significant association with OS in R/M-HNSCC patients (p= 0.05). In a multivariate analysis, our CRP kinetic classification (p= 0.007) and the outcome of the first re-staging (p= 0.002) were significant independent factors for OS. Discussion Our novel CRP kinetic classification significantly correlates with OS in R/M-HNSCC patients, indicating a potential prognostic marker. Existing classifications from other cancer entities showed limited prognostic significance, emphasizing the need for tailored markers. For validation, however, testing on larger R/M-HNSCC patient collectives is necessary.
引言 检查点抑制剂治疗早期C反应蛋白动力学特征及其预后价值已在多种肿瘤类型中得到研究，其中CRP的激增动态被描述为积极的预后参数。本回顾性研究旨在探讨该指标在复发或转移性头颈部鳞状细胞癌患者中的适用性。材料与方法 纳入2018年至2023年间在本中心接受CPI治疗的R/M-HNSCC患者（n=44），从电子病历系统中提取人口统计学、临床、组织病理学及实验室数据并进行统计分析。采用两种已发表的CRP动力学分类标准进行评估，同时提出新的分类方法，随后将分类结果与患者总生存期进行相关性分析。结果 在两种已发表的CRP动力学分类标准中，仅有一种与首次再分期结果存在关联，而两者均未显示与R/M-HNSCC患者OS的相关性。本研究提出的新型CRP动力学分类标准与R/M-HNSCC患者OS呈现显著相关性（p=0.05）。多变量分析显示，该新型CRP动力学分类（p=0.007）及首次再分期结果（p=0.002）均为OS的独立显著影响因素。讨论 本研究提出的新型CRP动力学分类标准与R/M-HNSCC患者OS显著相关，提示其可能成为潜在的预后标志物。现有其他肿瘤类型的分类标准在本队列中预后价值有限，这凸显了开发疾病特异性标志物的必要性。但该分类标准仍需在更大规模的R/M-HNSCC患者队列中进行验证。
肿瘤(癌症)患者之家