Fang Tianyi, Yin Xin, Wang Yufei, Zhang Lei, Yang Shuo, Jiang Xinju, Xue Yingwei
Department of Gastroenterological Surgery, Harbin Medical University Cancer Hospital, Harbin Medical University, Harbin, 150081, China.
Department of Pathology, Harbin Medical University, Harbin, 150081, China.
Heliyon. 2024 Feb 18;10(4):e26176. doi: 10.1016/j.heliyon.2024.e26176. eCollection 2024 Feb 29.
Tumor immunity plays an important role in assessing the tumor progression. The purpose of this study was to investigate the prognostic value of combined systemic inflammation response index (SIRI) and platelet-lymphocyte ratio (PLR) of gastroesophageal junction cancer (AEG) and upper gastric cancer (UGC) patients.
In this retrospective study, patients from 2003 to 2014 were divided into training and validation sets. The prognostic accuracy of each variable was compared using time-independent ROC analysis. The scoring system was calculated by cut-off values of SIRI and PLR in 5-year. Kaplan-Meier and Log-rank tests were used to analyze overall survival (OS). Chi-square test was used to analyze the association between clinical characteristics and the scoring system. Univariate and multivariate analyses based on the competitive risk regression model were used to analyze independent predictors of death due to AGC and UGC. R software was used to construct the Nomogram model of risk assessment.
Patients with SIRI-PLR = 2 had worse survival time than those with 0 and 1 ( < 0.001) and more suitable for postoperative adjuvant chemotherapy ( = 0.002). High PLR patients were more suitable for proximal gastrectomy ( = 0.049). SIRI-PLR were independent predictors in training set ( < 0.001), which could be combined with age, pTNM stage and postoperative chemotherapy to construct Nomogram for predicting OS.
Preoperative SIRI-PLR score was an independent predictor for patients with AEG and UGC. The Nomogram model constructed by age, SIRI-PLR, pTNM stage and postoperative chemotherapy can correctly predict the prognosis of patients.
肿瘤免疫在评估肿瘤进展中起着重要作用。本研究旨在探讨全身炎症反应指数(SIRI)与血小板淋巴细胞比值(PLR)联合对胃食管交界癌(AEG)和胃上部癌(UGC)患者的预后价值。
在这项回顾性研究中,将2003年至2014年的患者分为训练集和验证集。使用非时间依赖性ROC分析比较各变量的预后准确性。通过5年SIRI和PLR的临界值计算评分系统。采用Kaplan-Meier法和Log-rank检验分析总生存期(OS)。采用卡方检验分析临床特征与评分系统之间的关联。基于竞争风险回归模型进行单因素和多因素分析,以分析AGC和UGC导致死亡的独立预测因素。使用R软件构建风险评估列线图模型。
SIRI-PLR = 2的患者生存时间比SIRI-PLR为0和1的患者差(P < 0.001),且更适合术后辅助化疗(P = 0.002)。高PLR患者更适合近端胃切除术(P = 0.049)。SIRI-PLR在训练集中是独立预测因素(P < 0.001),可与年龄、pTNM分期和术后化疗相结合构建预测OS的列线图。
术前SIRI-PLR评分是AEG和UGC患者的独立预测因素。由年龄、SIRI-PLR、pTNM分期和术后化疗构建的列线图模型能够正确预测患者的预后。