全身免疫炎症指数（SII）和预后营养指数（PNI）在早期胃癌中的作用
The Effect of Systemic Immune-Inflammatory Index (SII) and Prognostic Nutritional Index (PNI) in Early Gastric Cancer.
作者信息
Jing Yaoyao, Ren Minghan, Li Xiaoxiao, Sun Xiaoyuan, Xiao Yan, Xue Juan, Liu Zimin
机构信息
Center for GI Cancer Diagnosis and Treatment, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, People's Republic of China.
Department of Gastroenterology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, People's Republic of China.
出版信息
J Inflamm Res. 2024 Dec 4;17:10273-10287. doi: 10.2147/JIR.S499094. eCollection 2024.
BACKGROUND
In recent years, the systemic immune-inflammatory index (SII) and prognostic nutritional index (PNI) have been considered potential predictors of survival outcomes in various solid tumors, including gastric cancer. However, there is a notable lack of research focusing on their prognostic implications specifically in the early stage of gastric cancer. This study aims to investigate the prognostic indicators of early gastric cancer (EGC), including neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), SII, PNI, and lymph node metastasis (LNM).
METHODS
In this retrospective analysis, we examined 490 patients diagnosed with EGC (pT1Nx). The peripheral blood indices of interest were SII, PNI, PLR, and NLR. The receiver operating characteristic (ROC) curves and the area under the ROC curve (AUC) were used to determine optimal cutoff values and prognostic efficacy for each parameter. Additionally, Kaplan-Meier survival curves and multivariate Cox regression models were utilized to delineate independent prognostic factors.
RESULTS
The optimal cutoff values for SII and PNI were determined as 613.05 and 42.21, respectively. Patients in the low SII (SII-L) group demonstrated significantly higher 5-year Disease-Free Survival (DFS) and Overall Survival (OS) rates of 94.7% and 96.2%, compared to the high SII (SII-H) group (DFS: 78.7%; OS: 81.9%), with both differences proving statistically significant (P < 0.001, P < 0.001). Similarly, patients in the high PNI (PNI-H) group showed superior 5-year DFS (93.3%) and OS rates (95.1%) versus the low PNI (PNI-L) group (DFS: 71.4%; OS: 74.3%), also demonstrating statistical significance (P < 0.001, P < 0.001). Multivariate analysis identified SII, PNI, and LNM as independent prognostic factors for EGC. A combined analysis of SII, PNI, and LNM yielded a C-index of 0.723 (P = 0.008).
CONCLUSION
SII, PNI, and LNM are effective markers for predicting the survival outcomes of patients undergoing radical gastrectomy for EGC.
背景
近年来，全身免疫炎症指数（SII）和预后营养指数（PNI）被认为是包括胃癌在内的各种实体瘤生存结局的潜在预测指标。然而，专门针对它们在胃癌早期阶段的预后意义的研究明显不足。本研究旨在探讨早期胃癌（EGC）的预后指标，包括中性粒细胞与淋巴细胞比值（NLR）、血小板与淋巴细胞比值（PLR）、SII、PNI和淋巴结转移（LNM）。
方法
在这项回顾性分析中，我们检查了490例诊断为EGC（pT1Nx）的患者。感兴趣的外周血指标为SII、PNI、PLR和NLR。采用受试者工作特征（ROC）曲线和ROC曲线下面积（AUC）来确定每个参数的最佳截断值和预后效能。此外，利用Kaplan-Meier生存曲线和多变量Cox回归模型来确定独立的预后因素。
结果
SII和PNI的最佳截断值分别确定为613.05和42.21。低SII（SII-L）组患者的5年无病生存率（DFS）和总生存率（OS）显著更高，分别为94.7%和96.2%，而高SII（SII-H）组的DFS为78.7%，OS为81.9%，两者差异均具有统计学意义（P < 0.001，P < 0.001）。同样，高PNI（PNI-H）组患者的5年DFS（93.3%）和OS率（95.1%）优于低PNI（PNI-L）组（DFS：71.4%；OS：74.3%），也具有统计学意义（P < 0.001，P < 0.001）。多变量分析确定SII、PNI和LNM为EGC的独立预后因素。SII、PNI和LNM的联合分析得出C指数为0.723（P = 0.008）。
结论
SII、PNI和LNM是预测接受EGC根治性胃切除术患者生存结局的有效标志物。
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