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全身免疫炎症指数对胆囊癌患者术后生存的预测价值。

The predictive value of systemic immune inflammation index for postoperative survival of gallbladder carcinoma patients.

作者信息

Chen Hao, Huang Zhiwei, Sun Bo, Wang Ankang, Wang Yanrong, Shi Hao, Zheng Tianxiang, Li Tongxi, Huang Meizhou, Fu Wenguang

机构信息

Department of General Surgery (Hepatobiliary Surgery), The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China.

Clinical Medical College, Southwest Medical University.

出版信息

J Surg Oncol. 2021 Jul;124(1):59-66. doi: 10.1002/jso.26470. Epub 2021 Mar 25.

Abstract

BACKGROUND

Growing evidence indicates that systemic immune inflammation index (SII) can predict the prognosis of various solid tumors. The objective of this study aimed to investigate the efficacy of SII in predicting the prognosis of gallbladder carcinoma (GBC) patients after radical surgery.

METHODS

A consecutive series of 93 patients with GBC who underwent radical resection were enrolled in the retrospective study. The cutoff value for the SII was calculated using the time-dependent receiver operating characteristic (ROC) curve analysis by overall survival (OS) prediction. The associations between the SII and the clinicopathologic characteristics were analyzed using Pearson's χ test and Fisher's exact test. Survival curves were calculated using the Kaplan-Meier method. Univariate analysis was performed to evaluate the prognostic relevance of preoperative parameters. The multivariate Cox regression proportional hazard model was used to assess variables significant on univariate analysis.

RESULTS

The Kaplan-Meier survival analysis and the multivariate analysis of patients with GBC who received radical resection showed SII independently predicted OS. The univariate analysis showed that the TNM stage, SII, CA19-9, ALP, prealbumin, NLR, MLR, lymph node metastasis, and histopathological type were all associated with overall survival. In time-dependent ROC analysis, the area of the SII-CA19-9 under the ROC curve (AUC) was higher than that of the preoperative SII or CA19-9 levels for the prediction of OS.

CONCLUSION

Our results demonstrate that high SII was a predictor of poor long-term outcomes among patients with GBC undergoing curative surgery. SII-CA19-9 classification may be more effective in predicting the postoperative prognosis of GBC patients.

摘要

背景

越来越多的证据表明,全身免疫炎症指数(SII)可以预测各种实体瘤的预后。本研究的目的是探讨SII在预测胆囊癌(GBC)患者根治性手术后预后的有效性。

方法

本回顾性研究纳入了93例接受根治性切除的GBC患者。通过总生存(OS)预测,使用时间依赖性受试者工作特征(ROC)曲线分析计算SII的临界值。使用Pearson卡方检验和Fisher精确检验分析SII与临床病理特征之间的关联。采用Kaplan-Meier法计算生存曲线。进行单因素分析以评估术前参数的预后相关性。使用多因素Cox回归比例风险模型评估单因素分析中有意义的变量。

结果

对接受根治性切除的GBC患者进行的Kaplan-Meier生存分析和多因素分析显示,SII独立预测OS。单因素分析表明,TNM分期、SII、CA19-9、碱性磷酸酶、前白蛋白、中性粒细胞与淋巴细胞比值(NLR)、单核细胞与淋巴细胞比值(MLR)、淋巴结转移和组织病理学类型均与总生存相关。在时间依赖性ROC分析中,SII-CA19-9在ROC曲线下的面积(AUC)高于术前SII或CA19-9水平用于预测OS的AUC。

结论

我们的结果表明,高SII是接受根治性手术的GBC患者长期预后不良的预测指标。SII-CA19-9分类在预测GBC患者术后预后方面可能更有效。

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