Study on the predictive value of pretreatment peripheral blood inflammatory markers regarding immunotherapy in patients with inoperable advanced or locally advanced oesophageal squamous cell carcinoma

Figures & data

Figure 1. The flowchart of the study on the predictive value of pretreatment peripheral blood inflammatory markers regarding immunotherapy in patients with inoperable advanced or locally advanced ESCC.

Table 1. Baseline characteristics of patients with inoperable advanced or locally advanced ESCC.

Classification		Number of cases (percentage)
Sex	Male	91 (85.0%)
	Female	16 (15.0%)
Age (years)		62.87 ± 8.61
	<65	58 (54.2%)
	≥65	49 (45.8%)
PS score	0–1	99 (92.5%)
	2	8 (7.5%)
Tumour location	Upper section	22 (20.1%)
	Middle section	35 (32.7%)
	Lower section	50 (46.7%)
Degree of differentiation	Low polarization	47 (43.9%)
	Middle polarization	50 (46.7%)
	High differentiation	10 (9.4%)
Tumour staging	III	48 (44.9%)
	IV	59 (55.1%)
Relocation site	Regional lymph nodes	98 (91.6%)
	Distant lymph nodes	42 (39.3%)
	Liver	14 (13.1%)
	Lung	21 (19.6%)
Radiotherapy	Yes	45 (42.1%)
	No	62 (57.9%)
Number of lines at immunotherapy	Front line	92 (86.0%)
	Second line and above	15 (14.0%)

Figure 2. ROC curves for peripheral blood inflammatory markers PIV, SII, NLR and PLR in patients with inoperable advanced or locally advanced ESCC prior to immunotherapy: The areas under the curve (AUC) for PIV, SII, NLR, and PLR were 0.833, 0.813, 0.810 and 0.535, the optimal cut-off values for PIV, SII, NLR, and PLR were 415.885, 834.295, 3.740 and 151.250.

Table 2. Optimal cut-off values of PIV, SII, NLR, and PLR.

Classification	Optimal cutoff value	Area under the curve(95% CI)	Sensitivity	Specificity
PIV	415.885	0.833(0.735–0.932)	90.9%	67.7%
SII	834.295	0.813(0.702–0.925)	90.9%	76.0%
NLR	3.740	0.810(0.700–0.919)	81.8%	76.0%
PLR	151.250	0.535(0.365–0.705)	81.8%	35.4%

Table 3. Effect of PIV, SII, NLR, and PLR on ORR and DCR of immunotherapy in patients with inoperable advanced or locally advanced ESCC.

Classification	Therapeutic effects				N(%)	ORR(%)	P	DCR(%)	P
	CR	PR	SD	PD
PIV							0.071		<0.001*
Low	0	36	29	1	66 (61.7)	54.5		98.5
High	0	15	16	10	41 (38.3)	45.5		75.6
SII							0.016*		<0.001*
Low	0	41	32	1	74 (69.2)	55.4		98.6
High	0	10	13	10	33 (30.8)	30.3		69.7
NLR							0.047*		<0.001*
Low	0	40	32	2	74 (69.2)	54.1		97.3
High	0	11	13	9	33 (30.8)	33.3		72.7
PLR							0.170		0.184
Low	0	22	15	2	39 (36.4)	56.4		94.9
High	0	29	30	9	68 (63.6)	42.6		86.8

1. Complete remission (CR), partial response (PR), stable disease (SD), disease progression (PD).

2. ORR = (CR + PR)/(CR + PR + SD + PD) × 100%, DCR = (CR + PR + SD)/(CR + PR + SD + PD) × 100%.

3. *p < 0.05, the difference is statistically significant.

Figure 3. Kaplan–Meier estimates of overall survival (OS) according to PIV (A), SII (B), NLR (C) and PLR (D).

Table 4. Univariate analysis of factors affecting PFS and OS in immunotherapy for inoperable advanced or locally advanced ESCC.

Factor	Median PFS (months)	95% CI	P	Median OS (months)	95% CI	P
Sex			0.924			0.919
Male	9.8	6.8–12.8		15.2	11.6–18.8
Female	8.0	5.4–10.6		19.8	4.9–34.7
Age (year)			0.489			0.827
<65	8.6	6.0–11.2		15.2	11.5–18.9
≥65	10.0	3.9–16.1		18.2	7.7–28.7
PS score			0.148			0.337
0–1	10.0	6.2–13.8		17.7	12.9–22.5
2	6.9	0.2–13.6		8.9	6.8–11.0
Tumour location			0.849			0.923
Upper	10.5	7.8–13.2		14.7	10.6–18.8
Middle	8.8	3.6–14.0		19.8	16.1–23.5
Lower	8.6	3.9–13.3		14.4	10.5–18.3
Degree of differentiation			0.932			0.865
Low polarization	8.0	6.1–9.9		14.4	8.1–20.7
Middle polarization	11.1	5.5–16.7		17.7	11.7–23.7
High differentiation	9.8	8.4–11.2		12.0	11.7–12.3
Tumour staging			0.001*			0.020*
III	18.3	9.4–27.2		24.0	NA
IV	8.0	6.4–9.6		14.3	11.3–17.3
Regional lymph node metastasis			0.514			0.926
No	10.5	7.9–13.1		14.3	0.6–28.0
Yes	9.3	6.1–12.5		17.3	12.6–22.0
Distant lymph node metastasis			0.032*			0.039*
No	12.6	6.0–19.2		20.4	12.2–28.6
Yes	8.6	6.8–10.4		14.3	13.1–15.6
Lung metastasis			0.030*			0.035*
No	11.9	7.0–16.8		18.2	11.5–24.9
Yes	8.4	7.2–9.6		15.2	13.4–17.0
Liver metastasis			<0.001*			0.002*
No	11.9	8.3–15.5		17.7	12.0–23.4
Yes	4.3	1.9–6.7		8.7	7.9–9.5
Radiotherapy			0.901			0.956
No	8.5	6.1–10.9		14.3	10.6–18.0
Yes	11.6	7.7–15.5		18.2	13.0–23.4
Number of lines at immunotherapy			0.207			0.507
Front line	9.8	7.1–12.5		15.2	11.6–18.8
Second line and above	7.7	0.0–18.7		17.9	4.4–31.4
PIV			<0.001*			<0.001*
Low	14.1	11.4–16.8		21.2	17.8–24.6
High	6.9	3.3–10.5		8.9	4.8–13.0
SII			<0.001*			<0.001*
Low	13.0	9.2–16.8		20.4	16.8–24.0
High	5.2	1.9–8.5		8.5	7.7–9.3
NLR			<0.001*			<0.001*
Low	13.0	9.3–16.7		19.4	15.6–23.2
High	6.9	3.6–10.2		8.4	6.9–9.9
PLR			0.889			0.827
Low	8.2	5.3–11.1		15.2	9.1–21.3
High	10.0	6.9–13.2		15.2	9.2–21.2

* p < 0.05, statistically significant difference.

Table 5. Multifactorial analysis of factors affecting PFS and OS in immunotherapy of inoperable advanced or locally advanced ESCC.

Factor	PFS		OS
	HR(95% CI)	P	HR(95% CI)	P
Tumour staging(IV vs. III)	2.0 (1.2–3.4)	0.010*	2.4 (1.4–4.1)	0.002*
Liver metastasis(Yes vs. No)	2.5 (1.3–5.0)	0.009*	/	/
SII(High vs. Low)	2.6 (1.5–4.4)	<0.001*	3.2 (1.9–5.4)	<0.001*

* p < 0.05, statistically significant difference.

Data availability statement

The data that support the findings of this study are available from the corresponding author XP Z upon reasonable request.