原发性肝癌患者介入治疗后全身免疫炎症指数与复发或转移的相关性——一项回顾性队列研究
Association between the systemic immune inflammation index and recurrence or metastasis after interventional therapy in patients with primary liver cancer- a retrospective cohort study.
作者信息
Yu Libao, Zheng Sheng, Yang Juan, Fu Zhipeng, Zhu Xing, Su Ke
机构信息
Department of Hepatobiliary Surgery, The Eighth Medical Center of PLA General Hospital, Beijing, China.
Department of Gastroenterology, The Third People's Hospital of Yunnan Province, Kunming, China.
出版信息
J Gastrointest Oncol. 2023 Apr 29;14(2):780-788. doi: 10.21037/jgo-23-104. Epub 2023 Apr 26.
BACKGROUND
The systemic immune inflammation index has been used to evaluate the prognosis of patients with a variety of malignant tumors. However, studies were limited in primary liver cancer (PLC) patients. This study aimed to investigate the association between the systemic immune inflammation index and recurrence or metastasis after interventional therapy in patients with PLC.
METHODS
From January 2016 to December 2017, 272 patients with PLC admitted to the 941st Hospital of PLA Joint Logistics Support Force were retrospectively collected. All patients received interventional treatment, there were no residual lesions after interventional treatment. The patients were followed up for 5 years to monitor the rates of recurrence or metastasis. The patients were divided into a recurrence or metastasis group (n=112) and a control group (n=160). The differences in clinical features between the 2 groups were compared, and the predictive value of systemic immune inflammation index on recurrence or metastasis after interventional treatment in patients with PLC was analyzed.
RESULTS
Compared with the control group (8.12%), the proportion of patients with ≥2 lesions in the recurrence or metastasis group (19.64%) was significantly increased (P=0.005); the proportion of patients with vascular invasion was significantly increased in the recurrence or metastasis group (10.71% 4.38%, P=0.044); albumin decreased significantly in the recurrence or metastasis group (39.69±6.17 41.69±6.82 g/L, P=0.014); neutrophils (%) were significantly increased in the recurrence or metastasis group (0.70±0.08 0.64±0.08, P<0.001); lymphocytes (%) were significantly reduced in the recurrence or metastasis group (0.25±0.06 0.30±0.06, P<0.001); and platelet count was significantly increased in the recurrence or metastasis group (179.22±39.52 160.81±34.13 10/L, P<0.001). The systemic immune inflammation index was significantly increased in the recurrence or metastasis group (535.23±174.05 357.84±120.21, P<0.001). Systemic immune inflammation index was valuable in predicting recurrence or metastasis, and the area under the curve was 0.795 (95% CI: 0.742-0.848, P<0.001). Systemic immune inflammation index >405.08 was an independent risk factor of recurrence or metastasis [relative risk (95% CI: 1.878-5.329), P=0.000].
CONCLUSIONS
Elevated systemic immune inflammation index is associated with recurrence or metastasis after interventional therapy in patients with PLC.
背景
全身免疫炎症指数已被用于评估多种恶性肿瘤患者的预后。然而，针对原发性肝癌（PLC）患者的研究有限。本研究旨在探讨PLC患者介入治疗后全身免疫炎症指数与复发或转移之间的关联。
方法
回顾性收集2016年1月至2017年12月解放军联勤保障部队第941医院收治的272例PLC患者。所有患者均接受介入治疗，介入治疗后无残留病灶。对患者进行5年随访，监测复发或转移率。将患者分为复发或转移组（n = 112）和对照组（n = 160）。比较两组临床特征的差异，分析全身免疫炎症指数对PLC患者介入治疗后复发或转移的预测价值。
结果
与对照组（8.12%）相比，复发或转移组中病灶≥2个的患者比例（19.64%）显著升高（P = 0.005）；复发或转移组中血管侵犯患者的比例显著升高（10.71%对4.38%，P = 0.044）；复发或转移组白蛋白显著降低（39.69±6.17对41.69±6.82 g/L，P = 0.014）；复发或转移组中性粒细胞（%）显著升高（0.70±0.08对0.64±0.08，P<0.001）；复发或转移组淋巴细胞（%）显著降低（0.25±0.06对0.30±0.06，P<0.001）；复发或转移组血小板计数显著升高（179.22±39.52对160.81±34.13×10⁹/L，P<0.001）。复发或转移组全身免疫炎症指数显著升高（535.23±174.05对357.84±120.21，P<0.001）。全身免疫炎症指数在预测复发或转移方面具有价值，曲线下面积为0.795（95%CI：0.742 - 0.848，P<0.001）。全身免疫炎症指数>405.08是复发或转移的独立危险因素[相对危险度（95%CI：1.878 - 5.329），P = 0.000]。
结论
PLC患者介入治疗后全身免疫炎症指数升高与复发或转移相关。
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