窦性心动过缓在信迪利单抗联合化疗治疗晚期胃腺癌疗效中的预测价值

Predictive Value of Sinus Bradycardia in the Efficacy of Sintilimab Combined with Chemotherapy for Advanced Gastric Adenocarcinoma

摘要: 目的：探讨窦性心动过缓在接受信迪利单抗联合化疗治疗晚期胃腺癌中的预后预测价值。方法：回顾性分析2022年1月1日至2025年1月1日在安徽医科大学第四附属医院(附属巢湖医院)接受信迪利单抗联合化疗一线治疗的晚期胃腺癌患者68例临床资料。评估窦性心动过缓(Sinus Bradycardia, SBc)与无进展生存期(PFS)的关系。结果：在68例患者中，16例(23.5%)患者发生SBc。发生SBc组患者的中位PFS显著优于未发生SBc组(11.1个月vs 5.9个月；P < 0.001)；未发生腹腔转移患者的PFS优于发生腹腔转移患者(6.7个月vs 5.1个月；P = 0.028)。COX回归分析表明SBc的发生是PFS的独立预测因子(HR6.176, 95% CI 2.349~16.240, P < 0.001)。结论：SBc与信迪利单抗联合化疗治疗胃腺癌患者的疗效相关，可能是一种抗肿瘤免疫反应的临床指标。

Abstract: Objective: To investigate the prognostic value of sinus bradycardia in patients with advanced gastric adenocarcinoma treated with sintilimab combined with chemotherapy. Methods: A retrospective analysis was conducted on the clinical data of 68 patients with advanced gastric adenocarcinoma who received first-line treatment with sintilimab combined with chemotherapy at the Fourth Affiliated Hospital of Anhui Medical University (Affiliated Chaohu Hospital) between January 1, 2022, and January 1, 2025. The relationship between sinus bradycardia (SBc) and progression-free survival (PFS) was evaluated. Results: Among the 68 patients, 16 (23.5%) developed SBc. The median PFS in the SBc group was significantly longer than that in the non-SBc group (11.1 months vs. 5.9 months; P < 0.001). COX regression analysis indicated that the occurrence of SBc was an independent predictor of PFS (HR 6.176, 95% CI 2.349~16.240, P < 0.001). Conclusion: SBc is associated with the efficacy of sintilimab combined with chemotherapy in patients with gastric adenocarcinoma and may serve as a clinical indicator of anti-tumor immune response.