ArticleJournal of inflammation research2025
Platelet Indices and ApoA1 as Predictive Markers in Neoadjuvant Immunochemotherapy for Locally Advanced Esophageal Squamous Cell Carcinoma: A Retrospective Study.
Article in Journal of inflammation research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Purpose: To evaluate the predictive value of baseline and preoperative blood parameters for treatment efficacy and prognosis in patients with locally advanced esophageal squamous cell carcinoma (LA-ESCC) undergoing neoadjuvant chemoimmunotherapy (nCIT) followed by radical surgery. Patients and Methods: This retrospective study analyzed clinical data from patients with LA-ESCC patients treated with nCIT followed by surgery (October 2019-November 2024). Patients were categorized based on pathological response (pathological complete response [pCR] and major pathological response [MPR]). Univariate and multivariate analyses identified factors associated with pCR and MPR. Cox regression and Kaplan-Meier methods were used to evaluate overall survival (OS) and disease-free survival (DFS). Nomograms and Receiver Operating Characteristic (ROC) curves were created for prognostic prediction. Results: Among 236 patients, the pCR rate was 31.8%, and the MPR rate was 51.7%. pCR was associated with improved DFS (Hazard Ratio [HR] = 0.27, 95% CI: 0.16-0.43, p < 0.0001) but not OS (p = 0.058). MPR was significantly correlated with both DFS (HR=0.27, 95% CI: 0.17-0.44, p < 0.0001) and OS (HR=0.38, 95% CI: 0.21-0.71, p = 0.0023). Identified predictors of treatment response included baseline and preoperative platelet indices (mean platelet volume [MPV], platelet distribution width [PDW], platelet-large cell ratio [P-LCR]) for both pCR and MPR, along with preoperative Apolipoprotein A1 (ApoA1) specifically for MPR (all identified as independent predictors on univariate and multivariate analysis, p < 0.05), reflecting their role in modulating the inflammatory response. A predictive model combining MPV (HR = 0.86, 95% CI: 0.61-1.22) and ApoA1 (HR = 0.24, 95% CI: 0.07-0.81) demonstrated good accuracy in forecasting DFS (30 months: AUC = 0.71, 95% CI: 0.60-0.81). Conclusion: Baseline and preoperative blood parameters (MPV, PDW, P-LCR) and preoperative ApoA1 are valuable predictors of treatment response and prognosis in LA-ESCC. Nomograms incorporating these markers offer reliable prognostic insights for DFS.
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