Li Ke-Jin, Zhang Zi-Yi, Sulayman Subinur, Shu Yin, Wang Kuan, Ababaike Saibihutula, Zeng Xiang-Yue, Zhao Ze-Liang
Department of Gastrointestinal Surgery, The Affiliated Cancer Hospital of Xinjiang Medical University, Urumqi 830000, Xinjiang Uygur Autonomous Region, China.
World J Gastrointest Surg. 2024 Dec 27;16(12):3794-3805. doi: 10.4240/wjgs.v16.i12.3794.
The prognosis of colorectal cancer (CRC) patients is notably influenced by both inflammation and nutritional status. The prognostic nutritional index (PNI) and systemic inflammatory response index (SIRI) have been reported in prognostic studies of various tumors. However, the efficacy of the combination of the two in predicting the prognosis of CRC patients has not been studied.
To evaluate the effectiveness of PNI and SIRI in predicting the prognosis of patients with CRC.
We retrospectively gathered data from 470 CRC patients who underwent feasible radical surgery at Xinjiang Cancer Hospital. The optimal cut-off values for SIRI and PNI, along with their predictive power for survival, were determined through area under the receiver operating characteristic curve using time-dependent receiver operating characteristic analysis. The Kaplan-Meier method and log-rank test were applied to assess prognostic impact, and a multifactorial Cox proportional hazards model was employed for analysis. Additionally, a new model, PSIRI, was developed and assessed for its survival prediction capability.
The optimal cutoff values for PNI and SIRI were determined to be 47.80 and 1.38, respectively. Based on these values, patients were categorized into high PNI and low PNI groups, as well as high SIRI and low SIRI groups. Significant differences in age, T stage, neutrophil to lymphocyte ratio (NLR), monocyte to lymphocyte ratio (MLR), and platelet-to-lymphocyte ratio (PLR) subgroups were observed between the PNI groups in the baseline profile. In the SIRI group, notable differences were found in gender, T stage, nerve invasion, intravascular tumor emboli, NLR, MLR, and PLR subgroups. Both low PNI and high SIRI were identified as independent risk factors for poor prognosis in CRC patients. When combined into the PSIRI model, it was shown that patients with a PSIRI ≤ 1 had a higher risk of death compared to those with a PSIRI of 2.
We assessed the impact of PNI and SIRI on the prognostic survival of CRC patients and developed a new model, PSIRI. This model demonstrated superior predictive accuracy, with a concordance index of 0.767.
结直肠癌（CRC）患者的预后受到炎症和营养状况的显著影响。预后营养指数（PNI）和全身炎症反应指数（SIRI）已在各种肿瘤的预后研究中有所报道。然而，两者联合在预测CRC患者预后方面的效果尚未得到研究。
评估PNI和SIRI在预测CRC患者预后方面的有效性。
我们回顾性收集了新疆肿瘤医院470例行可行根治性手术的CRC患者的数据。通过时间依赖性受试者工作特征分析，利用受试者工作特征曲线下面积确定SIRI和PNI的最佳截断值及其对生存的预测能力。采用Kaplan-Meier法和对数秩检验评估预后影响，并使用多因素Cox比例风险模型进行分析。此外，开发了一种新模型PSIRI，并评估其生存预测能力。
PNI和SIRI的最佳截断值分别确定为47.80和1.38。基于这些值，患者被分为高PNI组和低PNI组，以及高SIRI组和低SIRI组。在基线资料中，PNI组之间在年龄、T分期、中性粒细胞与淋巴细胞比值（NLR）、单核细胞与淋巴细胞比值（MLR）和血小板与淋巴细胞比值（PLR）亚组方面存在显著差异。在SIRI组中，在性别、T分期、神经侵犯、血管内肿瘤栓子、NLR、MLR和PLR亚组方面发现了显著差异。低PNI和高SIRI均被确定为CRC患者预后不良的独立危险因素。当合并到PSIRI模型中时，结果显示PSIRI≤1的患者比PSIRI为2的患者死亡风险更高。
我们评估了PNI和SIRI对CRC患者预后生存的影响，并开发了一种新模型PSIRI。该模型显示出卓越的预测准确性，一致性指数为0.767。
