全身性免疫炎症指数作为结直肠癌的预后生物标志物及其与原发肿瘤位置的变化关系。
Pan-immune-inflammation value as a prognostic biomarker for colon cancer and its variation by primary tumor location.
机构信息
Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China.
Medical Department of General Surgery, The First Medical Center, Chinese PLA General Hospital, Beijing 100853, China.
出版信息
World J Gastroenterol. 2024 Sep 7;30(33):3823-3836. doi: 10.3748/wjg.v30.i33.3823.
BACKGROUND
A growing body of research indicates significant differences between left-sided colon cancers (LCC) and right-sided colon cancers (RCC). Pan-immune-inflammation value (PIV) is a systemic immune response marker that can predict the prognosis of patients with colon cancer. However, the specific distinction between PIV of LCC and RCC remains unclear.
AIM
To investigate the prognostic and clinical significance of PIV in LCC and RCC patients.
METHODS
This multicenter retrospective cohort study included 1510 patients with colon cancer, comprising 801 with LCC and 709 with RCC. We used generalized lifting regression analysis to evaluate the relative impact of PIV on disease-free survival (DFS) in these patients. Kaplan-Meier analysis, as well as univariate and multivariate analyses, were used to examine the risk factors for DFS. The correlation between PIV and the clinical characteristics was statistically analyzed in these patients.
RESULTS
A total of 1510 patients {872 female patients (58%); median age 63 years [interquartile ranges (IQR): 54-71]; patients with LCC 801 (53%); median follow-up 44.17 months (IQR 29.67-62.32)} were identified. PIV was significantly higher in patients with RCC [median (IQR): 214.34 (121.78-386.72) 175.87 (111.92-286.84), < 0.001]. After propensity score matching, no difference in PIV was observed between patients with LCC and RCC [median (IQR): 182.42 (111.88-297.65) 189.45 (109.44-316.02); = 0.987]. PIV thresholds for DFS were 227.84 in LCC and 145.99 in RCC. High PIV (> 227.84) was associated with worse DFS in LCC [PIV-high: Adjusted hazard ratio (aHR) = 2.39; 95% confidence interval: 1.70-3.38; < 0.001] but not in RCC (PIV-high: aHR = 0.72; 95% confidence interval: 0.48-1.08; = 0.114).
CONCLUSION
These findings suggest that PIV may predict recurrence in patients with LCC but not RCC, underscoring the importance of tumor location when using PIV as a colon cancer biomarker.
背景
越来越多的研究表明，左半结肠癌（LCC）和右半结肠癌（RCC）之间存在显著差异。泛免疫炎症值（PIV）是一种系统性免疫反应标志物，可预测结肠癌患者的预后。然而，PIV 在 LCC 和 RCC 中的具体区别尚不清楚。
目的
探讨 PIV 在 LCC 和 RCC 患者中的预后和临床意义。
方法
本多中心回顾性队列研究纳入了 1510 例结肠癌患者，其中 801 例为 LCC，709 例为 RCC。我们使用广义提升回归分析评估 PIV 对这些患者无病生存期（DFS）的相对影响。采用 Kaplan-Meier 分析以及单因素和多因素分析来评估 DFS 的风险因素。对这些患者中 PIV 与临床特征之间的相关性进行统计学分析。
结果
共纳入 1510 例患者[872 例女性（58%）；中位年龄 63 岁[四分位间距（IQR）：54-71]；LCC 患者 801 例（53%）；中位随访时间 44.17 个月（IQR：29.67-62.32）]。RCC 患者的 PIV 显著较高[中位数（IQR）：214.34（121.78-386.72）比 175.87（111.92-286.84），<0.001]。经过倾向评分匹配后，LCC 和 RCC 患者的 PIV 无差异[中位数（IQR）：182.42（111.88-297.65）比 189.45（109.44-316.02）；=0.987]。DFS 的 PIV 截断值在 LCC 中为 227.84，在 RCC 中为 145.99。高 PIV（>227.84）与 LCC 患者的 DFS 较差相关[PIV-高：调整后的危险比（aHR）=2.39；95%置信区间：1.70-3.38；<0.001]，但在 RCC 中无相关性（PIV-高：aHR=0.72；95%置信区间：0.48-1.08；=0.114）。
结论
这些发现表明，PIV 可能预测 LCC 患者的复发，但不能预测 RCC 患者的复发，这强调了在将 PIV 用作结肠癌生物标志物时，肿瘤位置的重要性。
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