系统免疫炎症指数的变化可独立预测结直肠癌患者根治性切除术后的生存情况。

The Change of Systemic Immune-Inflammation Index Independently Predicts Survival of Colorectal Cancer Patients after Curative Resection.

机构信息

Department of Radiotherapy & Oncology, Nanjing Medical University Affiliated Suzhou Hospital, Suzhou, China.

Department of Radiotherapy, The Yancheng No. 1 People's Hospital, Yancheng, China.

出版信息

Mediators Inflamm. 2020 Nov 12;2020:4105809. doi: 10.1155/2020/4105809. eCollection 2020.

DOI:10.1155/2020/4105809

PMID:33293896

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7718069/

Abstract

BACKGROUND

The systemic immune-inflammation index (SII) has an important role in predicting survival in some solid tumors. However, little information is available concerning the change of the SII (∆SII) in colorectal cancer (CRC) after curative resection. This study was designed to evaluate the role of ∆SII in CRC patients who received surgery.

METHODS

A total 206 patients were enrolled in this study. Clinicopathologic characteristics and survival were assessed. The relationships between overall survival (OS), disease-free survival (DFS), and ∆SII were analyzed with both univariate Kaplan-Meier and multivariate Cox regression methods.

RESULTS

Based on the patient data, the receiver operating characteristic (ROC) optimal cutoff value of ∆SII was 127.7 for OS prediction. The 3-year and 5-year OS rates, respectively, were 60.4% and 36.7% in the high-∆SII group (>127.7) and 87.6% and 79.8% in the low-∆SII group (≤127.7). The 3-year and 5-year DFS rates, respectively, were 54.1% and 34.1% in the high-∆SII group and 80.3% and 78.5% in the low-∆SII group. In the univariate analysis, smoking, pathological stages III-IV, high-middle degree of differentiation, lymphatic invasion, vascular invasion, and the high-SII group were associated with poor OS. Adjuvant therapy, pathological stages III-IV, vascular invasion, and SII were able to predict DFS. Multivariate analysis revealed that pathological stages III-IV (HR = 0.442, 95% CI = 0.236-0.827, = 0.011), vascular invasion (HR = 2.182, 95% CI = 1.243-3.829, = 0.007), and the high-SII group (HR = 4.301, 95% CI = 2.517-7.350, < 0.001) were independent predictors for OS. Adjuvant therapy (HR = 0.415, 95% CI = 0.250-0.687, = 0.001), vascular invasion (HR = 3.305, 95% CI = 1.944-5.620, < 0.001), and the high-SII group (HR = 4.924, 95% CI = 2.992-8.102, < 0.001) were significant prognostic factors for DFS.

CONCLUSIONS

The present study demonstrated that ∆SII was associated with the clinical outcome in CRC patients undergoing curative resection, supporting the role of ∆SII as a prognostic biomarker.

摘要

背景

全身性免疫炎症指数（SII）在预测某些实体瘤的生存方面具有重要作用。然而，关于结直肠癌（CRC）根治性切除术后 SII（∆SII）变化的信息很少。本研究旨在评估∆SII 在接受手术的 CRC 患者中的作用。

方法

共纳入 206 例患者。评估了临床病理特征和生存情况。使用单变量 Kaplan-Meier 和多变量 Cox 回归方法分析了总生存（OS）、无病生存（DFS）与∆SII 的关系。

结果

根据患者数据，∆SII 的最佳截断值为 127.7，用于预测 OS。高∆SII 组（>127.7）的 3 年和 5 年 OS 率分别为 60.4%和 36.7%，低∆SII 组（≤127.7）分别为 87.6%和 79.8%。高∆SII 组的 3 年和 5 年 DFS 率分别为 54.1%和 34.1%，低∆SII 组分别为 80.3%和 78.5%。在单因素分析中，吸烟、病理分期 III-IV、高中度分化、淋巴血管侵犯和高 SII 组与 OS 不良相关。辅助治疗、病理分期 III-IV、血管侵犯和 SII 能够预测 DFS。多因素分析显示，病理分期 III-IV（HR = 0.442，95%CI = 0.236-0.827， = 0.011）、血管侵犯（HR = 2.182，95%CI = 1.243-3.829， = 0.007）和高 SII 组（HR = 4.301，95%CI = 2.517-7.350， < 0.001）是 OS 的独立预测因素。辅助治疗（HR = 0.415，95%CI = 0.250-0.687， = 0.001）、血管侵犯（HR = 3.305，95%CI = 1.944-5.620， < 0.001）和高 SII 组（HR = 4.924，95%CI = 2.992-8.102， < 0.001）是 DFS 的显著预后因素。