术前全身免疫炎症指数与胃癌根治术后患者预后的相关性分析：基于倾向评分匹配方法。
Correlation analysis between preoperative systemic immune inflammation index and prognosis of patients after radical gastric cancer surgery: based on propensity score matching method.
机构信息
Graduate School, Qinghai University, Xining, 810001, China.
Department of Gastrointestinal Surgery, Qinghai University Affiliated Hospital, Xining, 810001, China.
出版信息
World J Surg Oncol. 2022 Jan 3;20(1):1. doi: 10.1186/s12957-021-02457-2.
BACKGROUND
To explore the correlation between the preoperative systemic immune inflammation index (SII) and the prognosis of patients with gastric carcinoma (GC).
METHODS
The clinical data of 771 GC patients surgically treated in the Department of Gastrointestinal Surgery, Qinghai University Affiliated Hospital from June 2010 to June 2015 were retrospectively analyzed, and their preoperative SII was calculated. The optimal cut-off value of preoperative SII was determined using the receiver operating characteristic (ROC) curve, the confounding factors between the two groups were eliminated using the propensity score matching (PSM) method, and the correlation between preoperative SII and clinicopathological characteristics was assessed by chi-square test. Moreover, the overall survival was calculated using Kaplan-Meier method, the survival curve was plotted, and log-rank test was performed for the significance analysis between the curves. Univariate and multivariate analyses were also conducted using the Cox proportional hazards model.
RESULTS
It was determined by the ROC curve that the optimal cut-off value of preoperative SII was 489.52, based on which 771 GC patients were divided into high SII (H-SII) group and low SII (L-SII) group, followed by PSM in the two groups. The results of Kaplan-Meier analysis showed that before and after PSM, the postoperative 1-, 3-, and 5-year survival rates in L-SII group were superior to those in H-SII group, and the overall survival rate had a statistically significant difference between the two groups (P < 0.05). Before PSM, preoperative SII [hazard ratio (HR) = 2.707, 95% confidence interval (CI) 2.074-3.533, P < 0.001] was an independent risk factor for the prognosis of GC patients. After 1:1 PSM, preoperative SII (HR = 2.669, 95%CI 1.881-3.788, P < 0.001) was still an independent risk factor for the prognosis of GC patients.
CONCLUSIONS
Preoperative SII is an independent risk factor for the prognosis of GC patients. The increase in preoperative SII in peripheral blood indicates a worse prognosis.
背景
探讨术前全身免疫炎症指数（SII）与胃癌（GC）患者预后的相关性。
方法
回顾性分析 2010 年 6 月至 2015 年 6 月青海大学附属医院胃肠外科手术治疗的 771 例 GC 患者的临床资料，计算其术前 SII。采用受试者工作特征（ROC）曲线确定术前 SII 的最佳截断值，采用倾向评分匹配（PSM）法消除两组间混杂因素，采用卡方检验评估术前 SII 与临床病理特征的相关性。采用 Kaplan-Meier 法计算总生存率，绘制生存曲线，采用对数秩检验进行曲线间显著性分析。采用单因素和多因素 Cox 比例风险模型进行分析。
结果
ROC 曲线确定术前 SII 的最佳截断值为 489.52，根据该截断值将 771 例 GC 患者分为高 SII（H-SII）组和低 SII（L-SII）组，然后对两组进行 PSM。Kaplan-Meier 分析结果显示，PSM 前后，L-SII 组术后 1、3、5 年生存率均优于 H-SII 组，两组总体生存率差异有统计学意义（P<0.05）。PSM 前，术前 SII[风险比（HR）=2.707，95%置信区间（CI）2.074-3.533，P<0.001]是 GC 患者预后的独立危险因素。PSM 后 1：1，术前 SII（HR=2.669，95%CI 1.881-3.788，P<0.001）仍是 GC 患者预后的独立危险因素。
结论
术前 SII 是 GC 患者预后的独立危险因素。外周血中术前 SII 的增加表明预后更差。
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