免疫检查点抑制剂相关心脏毒性的严重程度和预后评估中的炎性生物标志物。
Inflammatory biomarkers in assessing severity and prognosis of immune checkpoint inhibitor-associated cardiotoxicity.
发表日期：2023 Mar 28
作者：
Lin Liang, Chanjuan Cui, Dan Lv, Yiqun Li, Liyan Huang, Jiayu Feng, Tao An, Pengchao Tian, Ke Yang, Linjun Hu, Lizhen Gao, Jian Zhang, Yuhui Zhang, Fei Ma, Yanfeng Wang
来源：
HEART & LUNG
摘要：
炎症生物标志物，包括CRP、中性粒细胞/淋巴细胞比值（NLR）和中性粒细胞/嗜酸性粒细胞比值（NER），可能预测肿瘤的结果。然而，它们在免疫检查点抑制剂（ICI）治疗相关的心毒性中的价值仍然不确定。我们旨在确定炎性标志物与ICI相关心毒性（iRCs）的严重程度和预后之间的关系。在2019年1月至2021年12月之间被诊断出iRCs的患者被回顾性地纳入研究，并根据iRC严重程度分为低（1-2级）和高（3-4级）分组。共纳入了47名患者。从第一次ICI输注到iRCs发作的中位事件时间为35天（IQR：19.0-65.5天）。与各自的基线值相比，在iRCs发作时心脏生物标志物和炎性标志物显著升高。与低级别iRCs相比，iRC发作时的NER在高级别iRCs的患者中显著增加（组别×时间，P < 0.01）。将iRC发作时的中位NER（184.33）分组后，NER≥184.33与高等级iRCs相关（OR：10.77，P < 0.05），且相比较较低NER组，死亡率增加了36.3%（HR：2.67，P < 0.05）。在出现iRCs的患者中，NER在iRCs发作时明显升高，较高的NER与更严重的iRC和更高的死亡率相关。需要更大的数据集来验证这些发现。© 2023 The Authors. 欧洲心脏病学会代表John Wiley＆Sons Ltd发表的ESC心力衰竭文章。
Inflammatory biomarkers, including CRP, the neutrophil-to-lymphocyte ratio (NLR), and the neutrophil-to-eosinophil ratio (NER), may predict outcomes in cancer. However, their value in immune checkpoint inhibitor (ICI) therapy-associated cardiotoxicity remains elusive. We aimed to characterize the relationship of inflammatory markers with severity of ICI-related cardiotoxicities (iRCs) and prognosis among patients with iRCs.Patients who were diagnosed with iRCs between January 2019 and December 2021 were retrospectively enrolled and were dichotomized based on iRC severity into low-grade (grade 1-2) vs. high-grade (grade 3-4) groups.Forty-seven patients were included. The median time-to-event from first ICI infusion to onset of iRCs was 35 days (IQR: 19.0-65.5 days). When compared with respective baseline values, cardiac biomarkers and inflammatory markers were significantly elevated at onset of iRCs. Compared with low-grade iRCs, NER at iRC onset was significantly increased among patients with high-grade iRCs (Group × Time, P < 0.01). When grouped by the median NER (184.33) at iRC onset, NER ≥ 184.33 was associated with high-grade iRCs (OR: 10.77, P < 0.05) and had a 36.3% increased mortality compared to the lower NER group (HR: 2.67, P < 0.05).In patients who develop iRCs, NER is significantly elevated at iRC onset, and higher NER correlates with greater iRC severity and higher mortality. Larger datasets are needed to validate these findings.© 2023 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology.