一种新型与炎症和胰岛素抵抗相关的指标，可预测癌症患者的生存情况。

A Novel Inflammation and Insulin Resistance Related Indicator to Predict the Survival of Patients With Cancer.

机构信息

Department of Gastrointestinal Surgery, Beijing Shijitan Hospital, Capital Medical University, Beijing, China.

Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, China.

出版信息

Front Endocrinol (Lausanne). 2022 Jun 20;13:905266. doi: 10.3389/fendo.2022.905266. eCollection 2022.

BACKGROUND

Systemic inflammation and insulin resistance (IR) are closely related in patients with cancer. However, there is no relevant indicator that combines inflammation and IR to predict patient prognosis. Therefore, this study aimed to develop and validate a novel inflammation- and IR-related marker in patients with cancer.

METHODS

The total cohort of this study included 5221 patients with cancer, and the training and validation cohorts were randomized in a 7:3 ratio. C-reactive protein (CRP) and fasting triglyceride glucose (TyG) were used to reflect patients' inflammation and IR status, respectively. The CRP-TyG index (CTI) was composed of CRP and TyG. The concordance (C)-index, receiver operator characteristic (ROC) curve, and calibration curve reflected the prognostic predictive power of CTI. Univariate and multivariate survival analyses predicted the prognostic value of CTI in patients with cancer.

RESULTS

The C-indices of CTI in patients with cancer were 0.636, 0.617, and 0.631 in the total, training, and validation cohorts, respectively. The 1-, 3-, and 5-year ROC and calibration curves showed that CTI had a good predictive ability of survival in patients with cancer. Meanwhile, patients with high CTI had a worse prognosis compared to patients with low CTI (total cohort: hazard ratio [HR] = 1.46, 95% confidence interval [95% CI] = 1.33-1.59; training cohort: HR = 1.36, 95% CI = 1.22-1.52; validation cohort: HR = 1.73, 95% CI = 1.47-2.04].

CONCLUSION

The CTI is a useful prognostic indicator of poor prognosis and a promising tool for treatment strategy decision-making in patients with cancer.

背景

癌症患者的系统性炎症和胰岛素抵抗（IR）密切相关。然而，目前尚无结合炎症和 IR 来预测患者预后的相关指标。因此，本研究旨在开发和验证一种新的癌症患者炎症和 IR 相关标志物。

方法

本研究的总队列包括 5221 例癌症患者，训练和验证队列按 7:3 的比例随机分组。C 反应蛋白（CRP）和空腹甘油三酯葡萄糖（TyG）分别用于反映患者的炎症和 IR 状态。CRP-TyG 指数（CTI）由 CRP 和 TyG 组成。一致性（C）指数、接收者操作特征（ROC）曲线和校准曲线反映了 CTI 的预后预测能力。单因素和多因素生存分析预测了 CTI 在癌症患者中的预后价值。

结果

癌症患者 CTI 的 C 指数分别为总队列 0.636、训练队列 0.617 和验证队列 0.631。1、3 和 5 年的 ROC 和校准曲线表明，CTI 对癌症患者的生存具有良好的预测能力。同时，高 CTI 患者的预后比低 CTI 患者差（总队列：风险比 [HR] = 1.46，95%置信区间 [95%CI] = 1.33-1.59；训练队列：HR = 1.36，95%CI = 1.22-1.52；验证队列：HR = 1.73，95%CI = 1.47-2.04）。