复发或转移性鼻咽癌抗PD-1治疗后BMI和代谢综合征与预后的相关性
Prognostic Associations of BMI and Metabolic Syndrome With Outcomes After Anti-PD-1 Therapy in Recurrent or Metastatic Nasopharyngeal Carcinoma.
文献信息
| PMID | 42714246 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Haoyu Zhang |
| 作者单位 | Department of Otolaryngology Head and Neck Surgery, Xiangya Hospital, Central South University, Changsha City, China. |
| 期刊 | Immunology |
| SCI 分区 | Q2 |
| IF | 6 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 鼻咽癌 |
中文摘要
目的： 评估体重指数（BMI）和代谢综合征（MetS）与接受抗PD-1治疗的复发或转移性鼻咽癌（R/M-NPC）患者预后之间的相关性，并开发总生存期（OS）的预后模型。方法：这项多中心回顾性研究纳入来自中国两家医院的238例BMI≥18.5 kg/m²的患者。采用中心校正、中心分层、分层和定量敏感性分析评估BMI和MetS的相关性。在湘雅队列中开发OS列线图，并在哈尔滨队列中进行外部评估。结果：在将暴露因素分别纳入的临床混杂因素校正模型中，高BMI与OS（HR，0.462；95% CI，0.324-0.657）和PFS（HR，0.511；95% CI，0.380-0.688）相关，MetS与OS（HR，0.433；95% CI，0.278-0.674）和PFS（无进展生存期）（HR，0.616；95% CI，0.439-0.866）相关。当BMI和MetS联合建模时，MetS与PFS的相关性减弱（HR，0.714；95% CI，0.504-1.012；p=0.058）。探索性生物标志物分析显示，联合阳性评分（CPS）和泛免疫炎症值（PIV）存在组间差异。各中心特异性效应方向一致，但外部中心的校准斜率为0.53（95% CI，0.08-0.98）。结论：在接受抗PD-1治疗、BMI≥18.5 kg/m²的中国R/M-NPC患者中，较高的BMI和MetS显示出预后相关性。这些观察性数据不能确立因果或治疗预测效应，需要在非中国人群及全体重谱中进行前瞻性验证。
英文摘要
To evaluate the associations of body mass index (BMI) and metabolic syndrome (MetS) with outcomes in patients with recurrent or metastatic nasopharyngeal carcinoma (R/M-NPC) receiving anti-PD-1 therapy, and to develop a prognostic model for overall survival (OS). This multicenter retrospective study included 238 patients with BMI ≥ 18.5 kg/m2 from two Chinese hospitals. BMI and MetS associations were evaluated using center-adjusted, center-stratified, hierarchical, and quantitative sensitivity analyses. An OS nomogram was developed in the Xiangya cohort and externally evaluated in the Harbin cohort. In clinical confounder-adjusted models with the exposures entered separately, high BMI was associated with OS (HR, 0.462; 95% CI, 0.324-0.657) and PFS (HR, 0.511; 95% CI, 0.380-0.688), and MetS was associated with OS (HR, 0.433; 95% CI, 0.278-0.674) and PFS (progression-free survival) (HR, 0.616; 95% CI, 0.439-0.866). When BMI and MetS were jointly modelled, the MetS-PFS association was attenuated (HR, 0.714; 95% CI, 0.504-1.012; p = 0.058). Exploratory biomarker analyses revealed group differences in combined positive score (CPS) and pan-immune-inflammation value (PIV). Center-specific effect directions were consistent, but the external-center calibration slope was 0.53 (95% CI, 0.08-0.98). Among anti-PD-1-treated Chinese patients with R/M-NPC and a BMI ≥ 18.5 kg/m2, higher BMI and MetS showed prognostic associations. These observational data do not establish causal or treatment-predictive effects, and prospective validation in non-Chinese populations across the full body-weight spectrum is needed.