Departmennt of Gastric Surgery, Union Hospital, Fujian Medical University, Fuzhou, Fujian, China.
Department of General Surgery, Fujian Medical University Union Hospital, Fuzhou, Fujian, China.
J Surg Oncol. 2021 Sep;124(3):282-292. doi: 10.1002/jso.26498. Epub 2021 Apr 29.
To investigate the effect of dynamic changes in systemic inflammatory markers (SIM) on long-term prognosis of patients with gastric cancer (GC).
A retrospective analysis was performed on the data of 2180 patients with GC who underwent radical gastrectomy in the Fujian medical university Union Hospital from January 2009 to December 2014. Changes in SIM between preoperatively and 1-6 months and 12 months postoperatively were reported.
In multivariate analysis, higher preoperative systemic inflammation score (pre-SIS) was independent predictor of poor prognosis (p < 0.05). The optimal time of remeasurement was 12 months postoperatively, based on a longitudinal profile of SIS and accuracy in predicting 5-year overall survival (OS) (area under the curve: 0.712 [95% confidence interval: 0.630-0.785]). According to the association between the conversion of SIS and OS, we classified patients into three risk groups. Kaplan-Meier curves showed significant differences in OS among risk groups. Further Cox multivariate regression analysis showed that only risk groups of SIS and pTNM stage were independent prognostic factors for OS.
The efficacy of SIS in predicting prognosis 12 months after surgery is superior, and the elevation of SIS 12 months after surgery predicts poor prognosis.
研究全身炎症标志物（SIM）的动态变化对胃癌（GC）患者长期预后的影响。
对 2009 年 1 月至 2014 年 12 月在福建医科大学附属协和医院接受根治性胃切除术的 2180 例 GC 患者的数据进行回顾性分析。报告了术前和术后 1-6 个月及 12 个月 SIM 的变化。
多因素分析显示，术前全身炎症评分（pre-SIS）较高是预后不良的独立预测因素（p<0.05）。基于 SIS 的纵向变化和预测 5 年总生存率（OS）的准确性，最佳复测时间为术后 12 个月（曲线下面积：0.712[95%置信区间：0.630-0.785]）。根据 SIS 转换与 OS 的关系，我们将患者分为三组。Kaplan-Meier 曲线显示 OS 在风险组之间存在显著差异。进一步的 Cox 多因素回归分析显示，只有 SIS 和 pTNM 分期的风险组是 OS 的独立预后因素。
SIS 在预测术后 12 个月预后的疗效较好，术后 12 个月 SIS 的升高预示着预后不良。
