评价新辅助免疫治疗食管鳞状细胞癌（ESCC）患者的安全性和有效性，并构建预后模型。回顾性收集接受新辅助免疫治疗和化疗的局部晚期食管鳞癌患者的临床资料。主要终点是主要病理缓解率和无病生存率，次要终点是治疗相关的不良事件和围手术期并发症。使用单变量和多变量逻辑回归分析影响病理反应的相关性，通过Boruta和最小绝对收缩和选择算子Cox回归分析筛选生存相关变量。构建了列线图，并利用受试者工作特征曲线和决策曲线分析来测试治疗的预测效果。总共入组了 181 名患者，其中 119 名 (66%) 患者接受了 3-4 个周期的治疗。 65.2% 的患者发生与治疗相关的不良事件，其中 13.3% 出现严重并发症。 68 名患者 (37.6%) 实现了主要病理缓解率，治疗周期组之间无显着差异 (P=0.925)。列线图包括病理TNM分期、淋巴血管侵犯、治疗后和手术后白蛋白水平以及治疗后全身免疫炎症指数。推导队列中的一年无病生存曲线下面积为 0.86（95%CI，0.75-0.97），验证队列中的一年无病生存曲线下面积为 0.75（95%CI，0.50-0.99），具有良好的校准性能。病理分期结合白蛋白水平和全身免疫炎症指数可能是接受新辅助免疫治疗的 ESCC 患者生存预后的较好预测因子。这项研究的结果提供了关于食管鳞癌新辅助免疫治疗的有效性和安全性的新证据，并提供了识别有复发风险的患者的工具。版权所有 © 2024 作者。由 Elsevier B.V. 出版。保留所有权利。

To evaluate the safety and efficacy of neoadjuvant immunotherapy in patients with esophageal squamous cell carcinoma (ESCC) and construct a prognostic model.Clinical data were retrospectively collected from patients with locally advanced ESCC who received neoadjuvant immunotherapy and chemotherapy. The primary endpoints were major pathologic remission rate and disease-free survival, and secondary endpoints were treatment-related adverse events and perioperative complications. Correlates affecting pathological response were analyzed using univariate and multivariate logistic regression, survival-related variables were screened by Boruta and least absolute shrinkage and selection operator Cox regression analysis. A nomogram was constructed and utilized to test the predictive efficacy of the treatment with receiver operating characteristic curve and decision curve analysis.A total of 181 patients were enrolled, of whom 119 (66 %) patients received 3-4 cycles of treatment. Treatment-related adverse events occurred in 65.2 % of the patients, with 13.3 % experiencing severe complications. Major pathological remission rate was achieved in 68 (37.6 %) patients, with no significant difference between the treatment cycle groups (P=0.925). The nomogram included pathologic TNM stage, lymphovascular invasion, post-treatment and post-surgery albumin levels, and post-treatment systemic immune-inflammation index. One-year disease-free survival area under the curve was 0.86 (95 %CI, 0.75-0.97) in the derivation cohort and 0.75 (95 %CI, 0.50-0.99) in the validation cohort, with good calibration performance.Pathological staging combined with albumin level and systemic immune-inflammation index could be a superior predictor of survival prognosis in ESCC patients receiving neoadjuvant immunotherapy. The findings of this study yield new evidence regarding the efficacy and safety of neoadjuvant immunotherapy in ESCC and provide a tool for identifying patients at risk of recurrence.Copyright © 2024 The Author(s). Published by Elsevier B.V. All rights reserved.