Liu Zhenhua, Ge Haijue, Miao Zhilong, Shao Shoupeng, Shi Hongtai, Dong Congsong
Department of Radiotherapy, The First People's Hospital of Yancheng, Yancheng, China.
Department of Gastroenterology, The Third People's Hospital of Yancheng, Yancheng, China.
Front Oncol. 2021 Feb 25;11:577043. doi: 10.3389/fonc.2021.577043. eCollection 2021.
The systemic inflammation response index (SIRI) has been revealed to be closely related to the prognosis of a variety of tumors. Whether the dynamic change in SIRI before and after surgery can be used to judge the prognosis of patients after radical gastrectomy has not yet been studied. In this study, the predictive ability of preoperative SIRI and changes in SIRI before and after surgery for the survival rate of gastric cancer patients was evaluated in two independent cohorts. It was found that SIRI was closely related to TNM staging. The higher the TNM stage, the higher the proportion of patients with a high SIRI. However, SIRI was not related to any other clinicopathological parameters. Kaplan-Meier survival analysis showed that a high SIRI was associated with poor prognosis in gastric cancer patients in the original cohort and in the validation cohort. SIRI, NLR, PLR, and MLR could be used to judge the prognosis of patients with operable gastric cancer. However, multivariate analysis suggested that only SIRI was an independent prognostic factor for patients with operable gastric cancer. In addition, the change in SIRI at 4 to 6 weeks after surgery compared with SIRI before surgery was closely related to the survival of gastric cancer patients. Compared with the unchanged group (absolute variation <50%), gastric cancer patients with a SIRI increase >50% had a worse OS, while patients with a SIRI decrease >50% had a better prognosis. In conclusion, SIRI can be used as a reliable index to evaluate the prognosis of patients with operable gastric cancer, and the dynamic change in SIRI before and after surgery is significantly related to the prognosis of patients with gastric cancer.
全身炎症反应指数（SIRI）已被证实与多种肿瘤的预后密切相关。手术前后SIRI的动态变化是否可用于判断根治性胃切除术后患者的预后尚未见研究报道。本研究在两个独立队列中评估了术前SIRI及手术前后SIRI变化对胃癌患者生存率的预测能力。结果发现，SIRI与TNM分期密切相关。TNM分期越高，SIRI高的患者比例越高。然而，SIRI与其他任何临床病理参数均无关。Kaplan-Meier生存分析显示，在原始队列和验证队列中，高SIRI均与胃癌患者的不良预后相关。SIRI、中性粒细胞与淋巴细胞比值（NLR）、血小板与淋巴细胞比值（PLR）及单核细胞与淋巴细胞比值（MLR）均可用于判断可手术胃癌患者的预后。然而，多因素分析提示，只有SIRI是可手术胃癌患者的独立预后因素。此外，术后4至6周时SIRI相对于术前的变化与胃癌患者的生存密切相关。与无变化组（绝对变化<50%）相比，SIRI升高>50%的胃癌患者总生存期（OS）较差，而SIRI降低>50%的患者预后较好。总之，SIRI可作为评估可手术胃癌患者预后的可靠指标，且手术前后SIRI的动态变化与胃癌患者的预后显著相关。
