系统性免疫炎症指数预测结直肠癌根治术后肿瘤复发。

Systemic Immune-Inflammation Index Predicts Tumor Recurrence after Radical Resection for Colorectal Cancer.

机构信息

Department of Surgery, Sagamidai Hospital.

Department of Lower Gastrointestinal Surgery, Kitasato University School of Medicine.

出版信息

Tohoku J Exp Med. 2023 Nov 25;261(3):229-238. doi: 10.1620/tjem.2023.J074. Epub 2023 Sep 7.

Abstract

The systemic inflammatory response is associated with tumor promotion and suppression. Accumulating evidence shows that peripheral blood markers of inflammatory response predict clinical outcomes in various human cancers. The aim of this study was to investigate the prognostic relevance of the inflammation-based biomarkers in colorectal cancer (CRC). We retrospectively analyzed 118 CRC patients who underwent curative resection between 2012 and 2017. The inflammation-based biomarkers were evaluated by using preoperative neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), systemic immune-inflammation index (SII), systemic inflammation response index (SIRI), prognostic nutritional index (PNI), and Glasgow prognostic score (GPS). Prognostic values were assessed by the Kaplan-Meier analysis for cancer-specific recurrence-free survival (RFS) and Cox proportional-hazards model. There were significant differences in the levels of NLR, PLR, SII, and SIRI between recurrence and non-recurrence group. The area under the curve (AUC) for SII was 0.710, which showed the highest value in the inflammation-based biomarkers. Multivariate analysis identified that SII (p = 0.0031) and lymph node metastasis (p = 0.0168) were independent prognostic factors for recurrence. High SII exhibited more dismal RFS than low SII in CRC patients with non-metastatic lymph node (p = 0.0002). Our study suggests that SII and lymph node metastasis could be useful indicators in predicting the recurrence of CRC patients. Additionally, SII could accurately stratify CRC patients with tumor recurrence by combining with lymph node metastasis. This result would be beneficial for determining the optimal therapeutic strategies after surgical resection for CRC.

摘要

全身炎症反应与肿瘤的促进和抑制有关。越来越多的证据表明,外周血炎症反应标志物可预测各种人类癌症的临床结局。本研究旨在探讨结直肠癌(CRC)中基于炎症的生物标志物的预后相关性。我们回顾性分析了 2012 年至 2017 年间接受根治性切除术的 118 例 CRC 患者。使用术前中性粒细胞与淋巴细胞比值(NLR)、血小板与淋巴细胞比值(PLR)、淋巴细胞与单核细胞比值(LMR)、全身免疫炎症指数(SII)、全身炎症反应指数(SIRI)、预后营养指数(PNI)和格拉斯哥预后评分(GPS)评估基于炎症的生物标志物。通过 Kaplan-Meier 分析评估癌症特异性无复发生存(RFS)和 Cox 比例风险模型评估预后价值。复发组和非复发组之间 NLR、PLR、SII 和 SIRI 的水平存在显著差异。SII 的曲线下面积(AUC)为 0.710,在基于炎症的生物标志物中具有最高值。多变量分析确定 SII(p = 0.0031)和淋巴结转移(p = 0.0168)是复发的独立预后因素。在无淋巴结转移的 CRC 患者中,高 SII 比低 SII 表现出更差的 RFS(p = 0.0002)。我们的研究表明,SII 和淋巴结转移可能是预测 CRC 患者复发的有用指标。此外,SII 结合淋巴结转移可准确分层有肿瘤复发的 CRC 患者。这一结果有助于确定 CRC 手术后的最佳治疗策略。

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