全身免疫炎症指数预测结直肠癌预后。
Systemic immune-inflammation index for predicting prognosis of colorectal cancer.
机构信息
Gastrointestinal Surgery Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, Guangdong Province, China.
出版信息
World J Gastroenterol. 2017 Sep 14;23(34):6261-6272. doi: 10.3748/wjg.v23.i34.6261.
AIM
To investigate the clinical significance of preoperative systemic immune-inflammation index (SII) in patients with colorectal cancer (CRC).
METHODS
A retrospective analysis of 1383 cases with CRC was performed following radical surgery. SII was calculated with the formula SII = (P × N)/L, where P, N, and L refer to peripheral platelet, neutrophil, and lymphocyte counts, respectively. The clinicopathological features and follow-up data were evaluated to compare SII with other systemic inflammation-based prognostic indices such as the neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) in patients with CRC.
RESULTS
The optimal cut-off point for SII was defined as 340. The overall survival (OS) and disease-free survival (DFS) were better in patients with low NLR, PLR, and SII ( < 0.05). The SII was an independent predictor of OS and DFS in multivariate analysis. The area under the receiver-operating characteristics (ROC) curve for SII (0.707) was larger than those for NLR (0.602) and PLR (0.566). In contrast to NLR and PLR, SII could effectively discriminate between the TNM subgroups.
CONCLUSION
SII is a more powerful tool for predicting survival outcome in patients with CRC. It might assist the identification of high-risk patients among patients with the same TNM stage.
目的
探讨术前全身免疫炎症指数(SII)在结直肠癌(CRC)患者中的临床意义。
方法
对 1383 例接受根治性手术的 CRC 患者进行回顾性分析。SII 采用公式 SII =(P×N)/L 计算,其中 P、N 和 L 分别代表外周血小板、中性粒细胞和淋巴细胞计数。评估临床病理特征和随访数据,以比较 SII 与其他基于全身炎症的预后指标(如中性粒细胞-淋巴细胞比(NLR)和血小板-淋巴细胞比(PLR))在 CRC 患者中的差异。
结果
SII 的最佳截断点定义为 340。低 NLR、PLR 和 SII(<0.05)患者的总生存期(OS)和无病生存期(DFS)更好。多因素分析显示,SII 是 OS 和 DFS 的独立预测因子。SII 的受试者工作特征(ROC)曲线下面积(AUC)(0.707)大于 NLR(0.602)和 PLR(0.566)。与 NLR 和 PLR 相比,SII 可以有效区分 TNM 亚组。
结论
SII 是预测 CRC 患者生存结局的更有力工具。它可以帮助识别相同 TNM 分期的高危患者。