【摘要】 目的 基于决策曲线分析不可切除食管癌患者血清胰岛素样生长因子1(IGF-1)、白介素8(IL-8)水平与诱导化疗序贯放化疗预后的关系。方法 选取2018年1月—2021年1月安徽医科大学第一附属医院肿瘤放疗科和合肥市第二人民医院肿瘤放疗科收治不可切除食管癌患者110例作为研究对象，均接受诱导化疗序贯放化疗治疗，根据预后分为良好组58例、不良组52例，分析2组患者的基线资料，Logistic分析血清IGF-1、IL-8水平与不可切除食管癌患者诱导化疗序贯放化疗预后的关系，ROC分析二者预测患者预后不良的价值。结果 放化疗结束且随访1个月时，完全缓解2例，部分缓解56例，稳定38例，进展14例，预后良好58例(52.73%),预后不良52例(47.27%);不良组患者治疗前血清IGF-1、IL-8、癌胚抗原(CEA)、细胞角蛋白19可溶性片段(CYFRA21-1)高于良好组，差异有统计学意义(t=4.986、6.879、5.882、7.021,P均<0.001),血清IGF-1、IL-8、CEA、CYFRA21-1过表达均是不可切除食管癌患者诱导化疗序贯放化疗预后不良的危险因素[OR(95%CI)=1.020(1.002～1.038)、1.154(1.062～1.253)、1.231(1.085～1.398)、2.973(1.552～5.696)];血清IGF-1、IL-8水平及二者联合预测不可切除食管癌患者诱导化疗序贯放化疗预后不良风险的AUC为0.758、0.819、0.841;绘制决策曲线结果显示，在阈值0.21～0.36、0.38～0.89范围内，联合血清IGF-1、IL-8水平的预测模型预测不可切除食管癌患者诱导化疗序贯放化疗预后不良的净受益率优于单独指标。结论 血清IGF-1、IL-8水平与不可切除食管癌患者诱导化疗序贯放化疗预后有关，二者可预测其预后不良风险，且联合预测净收益率更高。更多还原

【Abstract】 Objective To analyze the relationship between serum insulin-like growth factor 1(IGF-1) and interleukin 8(IL-8) levels and the prognosis of induction chemotherapy followed by chemoradiotherapy in patients with unresectable esophageal cancer based on decision curve.Methods A total of 110 patients with unresectable esophageal cancer who were admitted to the Department of Radiation Oncology, The First Affiliated Hospital of Anhui Medical University and Hefei Second People’s Hospital from January 2018 to January 2021 were selected as the research subjects. 52 cases in the unresectable group, the baseline data of the two groups were analyzed, the relationship between serum IGF-1 and IL-8 levels and the prognosis of patients with unresectable esophageal cancer after induction chemotherapy followed by chemoradiotherapy was analyzed, and the value of the two in predicting the poor prognosis of patients was analyzed by ROC.Results At the end of chemoradiotherapy and follow-up for 1 month, 2 cases had complete remission, 56 cases had partial remission, 38 cases were stable, 14 cases progressed, 58 cases(52.73%) had good prognosis, and 52 cases(47.27%) had poor prognosis. Before treatment, the serum levels of IGF-1, IL-8, carcinoembryonic antigen(CEA) and cytokeratin 19 soluble fragment(CYFRA21-1) in the poor group were higher than those in the good group, and the differences were statistically significant(t=4.986, 6.879, 5.882, 7.021,all P<0.001), serum IGF-1, IL-8, CEA, and CYFRA21 1 overexpression were risk factors for poor prognosis in patients with unresectable esophageal cancer after induction chemotherapy followed by chemoradiotherapy [OR(95%CI)=1.020(1.002-1.038), 1.154(1.062-1.253), 1.231(1.085-1.398), 2.973(1.552-5.696)]. The AUCs of serum IGF-1 and IL-8 levels and their combination in predicting the poor prognosis of patients with unresectable esophageal cancer after induction chemotherapy followed by chemoradiotherapy were 0.758, 0.819, and 0.841. The results of the decision curve drawing showed that, within the thresholds of 0.21-0.36 and 0.38-0.89, the combined prediction model of serum IGF-1 and IL-8 levels predicted the net benefit rate of poor prognosis in patients with unresectable esophageal cancer after induction chemotherapy followed by chemoradiotherapy was better than the single index.Conclusion Serum levels of IGF-1 and IL-8 are associated with the prognosis of patients with unresectable esophageal cancer after induction chemotherapy followed by chemoradiotherapy, they can predict the risk of poor prognosis, and the combined prediction of the net yield is higher.更多还原