Li Mingxuan, Bai Jiwei, Wang Shuai, Zhai Yixuan, Zhang Shuheng, Li Chuzhong, Du Jiang, Zhang Yazhuo
Beijing Neurosurgical Institute, Capital Medical University, Beijing, China.
Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Front Oncol. 2021 Feb 25;11:548325. doi: 10.3389/fonc.2021.548325. eCollection 2021.
Inflammation associated markers and nutritional indexes are associated with survival, and act as novel prognostic grading systems in patients with cancer, though the role of these markers in chordoma remains unclear. The current study aimed to characterize systemic immune-inflammation index (SII) and prognostic nutritional index (PNI), and their relationship with clinicopathological data and survival in skull base chordoma. Our retrospective study enrolled 183 patients with primary skull base chordoma who received surgical treatment. Clinicopathological data and preoperative blood tests including neutrophil, lymphocyte, platelet counts and albumin level were collected from medical records. Neutrophil lymphocyte ratio (NLR), platelet lymphocyte ratio (PLR), SII, PNI were calculated and the optimal cut-off values of these markers were used for further survival analysis via Kaplan-Meier survival analysis and Cox proportional hazards regression analysis. The value of NLR, PLR, SII, and PNI in skull base chordoma ranged from 0.44-6.48, 45.36-273.94, 113.37-1761.45, and 43.40-70.65, respectively. PNI was significantly correlated with patients' sex ( = 0.005) and age ( = 0.037). SII was positively correlated with NLR and PLR, but negatively correlated with PNI. The median overall survival (OS) time was 74.0 months and Kaplan-Meier survival analysis indicated that all four indexes were associated with OS. Multivariable Cox proportional hazards regression analysis identified that high SII was an independent prognostic factor for poor OS. More importantly, patients with high SII and PNI had the worst outcomes and combined use of SII and PNI increased the predictive ability for patients' survival in skull base chordoma. Our results suggest SII and PNI may be effective prognostic indicators of OS for patients with primary skull base chordoma after surgical resection.
炎症相关标志物和营养指标与生存率相关，并在癌症患者中作为新的预后分级系统，尽管这些标志物在脊索瘤中的作用仍不清楚。本研究旨在描述全身免疫炎症指数（SII）和预后营养指数（PNI），及其与颅底脊索瘤临床病理数据和生存率的关系。我们的回顾性研究纳入了183例接受手术治疗的原发性颅底脊索瘤患者。从病历中收集临床病理数据和术前血液检查，包括中性粒细胞、淋巴细胞、血小板计数和白蛋白水平。计算中性粒细胞淋巴细胞比值（NLR）、血小板淋巴细胞比值（PLR）、SII、PNI，并通过Kaplan-Meier生存分析和Cox比例风险回归分析，使用这些标志物的最佳临界值进行进一步的生存分析。NLR、PLR、SII和PNI在颅底脊索瘤中的值分别为0.44 - 6.48、45.36 - 273.94、113.37 - 1761.45和43.40 - 70.65。PNI与患者性别（= 0.005）和年龄（= 0.037）显著相关。SII与NLR和PLR呈正相关，但与PNI呈负相关。中位总生存（OS）时间为74.0个月，Kaplan-Meier生存分析表明所有四个指标均与OS相关。多变量Cox比例风险回归分析确定高SII是OS不良的独立预后因素。更重要的是，高SII和PNI的患者预后最差，SII和PNI联合使用提高了颅底脊索瘤患者生存的预测能力。我们的结果表明，SII和PNI可能是原发性颅底脊索瘤患者手术切除后OS的有效预后指标。
