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术前炎症负荷指数对接受根治性切除术的食管鳞状细胞癌预后的评估作用

Preoperative inflammatory burden index for prognostication in esophageal squamous cell carcinoma undergoing radical resection.

作者信息

Zhao Qiang, Wang Liang, Yang Xun, Feng Jifeng, Chen Qixun

机构信息

Department of Thoracic Surgery, Hangzhou Institute of Medicine (HIM), Key Laboratory Diagnosis and Treatment Technology on Thoracic Oncology, Zhejiang Cancer Hospital, Chinese Academy of Sciences, Hangzhou, Zhejiang province, China.

Key Laboratory Diagnosis and Treatment Technology on Thoracic Oncology, Zhejiang Cancer Hospital, Hangzhou, Zhejiang province, China.

出版信息

Sci Rep. 2024 Dec 28;14(1):30811. doi: 10.1038/s41598-024-81237-w.

Abstract

BACKGROUND

The Inflammatory burden Index (IBI) is an effective predictor for a range of malignancies. However, the significance of IBI in esophageal squamous cell carcinoma (ESCC) needs to be further verified. The aim of this study was to verify the predictive power of IBI in ESCC undergoing radical resection.

METHODS

The current retrospective study, which comprised 408 ESCC patients randomized into either the primary or validation cohort, evaluated the relationships between IBI, clinical characteristics, and cancer-specific survival (CSS). Additionally, the nomogram model was also constructed and verified.

RESULTS

The IBI is significantly related to tumor length, vessel invasion, perineural invasion, and TNM stage. Compared to other hematological indices, the decision curve analyses (DCA) and receiver operating characteristic curve (ROC) confirmed the higher prognostic value of IBI, indicating the better clinical applicability. In patients with high IBI compared to the low IBI cohort, the 5-year CSS was considerably worse (total: 27.0% vs. 59.1%, P < 0.001; primary: 25.0% vs. 58.9%, P < 0.001; validation: 31.7% vs. 59.7%, P = 0.002). The IBI was shown to be an independent parameter by multivariate analyses (primary: HR = 2.352, P < 0.001; validation: HR = 1.683, P = 0.045). Finally, with the C-index of 0.675 (0.656-0.695) in the primary set and 0.662 (0.630-0.694) in the validation set for CSS in ESCC, an IBI-based nomogram was created and validated.

CONCLUSION

The predictive significance of IBI in ESCC patients undergoing radical resection was validated by this investigation. IBI may be utilized for preoperative evaluation of ESCC as it was found to be substantially correlated with prognosis.

摘要

背景

炎症负荷指数(IBI)是一系列恶性肿瘤的有效预测指标。然而,IBI在食管鳞状细胞癌(ESCC)中的意义尚需进一步验证。本研究旨在验证IBI在接受根治性切除的ESCC中的预测能力。

方法

本项回顾性研究纳入了408例ESCC患者,随机分为原发队列或验证队列,评估了IBI、临床特征与癌症特异性生存(CSS)之间的关系。此外,还构建并验证了列线图模型。

结果

IBI与肿瘤长度、血管侵犯、神经周围侵犯及TNM分期显著相关。与其他血液学指标相比,决策曲线分析(DCA)和受试者工作特征曲线(ROC)证实了IBI具有更高的预后价值,表明其临床适用性更好。与低IBI队列相比,高IBI患者的5年CSS明显更差(总体:27.0%对59.1%,P<0.001;原发队列:25.0%对58.9%,P<0.001;验证队列:31.7%对59.7%,P = 0.002)。多因素分析显示IBI是一个独立参数(原发队列:HR = 2.352,P<0.001;验证队列:HR = 1.683,P = 0.045)。最后,基于ESCC患者CSS的C指数在原发组为0.675(0.656 - 0.695),在验证组为0.662(0.630 - 0.694),创建并验证了基于IBI的列线图。

结论

本研究验证了IBI在接受根治性切除的ESCC患者中的预测意义。由于发现IBI与预后密切相关,因此可用于ESCC的术前评估。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0a89/11680590/0dc53ec8e530/41598_2024_81237_Fig1_HTML.jpg

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