Wang Sisi, Feng Yuhua, Ling Jie, Zhao Xiayan, Hu Yanming, Hou Tao, Xie Yangchun
Department of Oncology, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China.
Department of Oncology and Hematology, Turpan City People's Hospital, Turpan, Xinjiang, China.
Mediators Inflamm. 2025 Mar 10;2025:6618728. doi: 10.1155/mi/6618728. eCollection 2025.
This study aimed to investigate the prognostic significance of the platelet-to-platelet distribution width ratio (P/PDW), systemic inflammation response index (SIRI), and systemic immune inflammation index (SII) in patients with locally advanced nasopharyngeal carcinoma (LA-NPC). A total of 549 LA-NPC patients were included in this retrospective analysis. Clinicopathological characteristics and blood test data were obtained from patient records. Receiver operating characteristic (ROC) curve analysis was employed to determine the optimal cutoff values for P/PDW, SIRI, and SII. The test was used to compare clinicopathological characteristics. Survival rates were calculated using the Kaplan-Meier method. Prognostic factors were evaluated using univariate and multivariate analyses via Cox regression. Additionally, we developed a nomogram to predict outcomes and assessed its acuracy using the concordance index (C-index) and a calibration curve. The median follow-up time was 47.1 months. Elevated P/PDW levels were associated with advanced N stages and higher risks of disease progression (all < 0.05). Patients with high SIRI or SII levels were more likely to have advanced T stages, clinical stages, and to develop metastasis (all < 0.05). Univariate analysis revealed that P/PDW, SIRI, SII, and T stage were significantly correlated with both overall survival (OS) and progression-free survival (PFS; all < 0.05). Clinical stage was significantly related only to PFS (=0.009). Multivariate Cox regression analysis identified P/PDW (hazard ratio (HR): 0.544, 95% confidence interval (CI): 0.390-0.759, < 0.001; HR: 0.406, 95% CI: 0.268-0.615, < 0.001) and T stage (HR: 0.539, 95% CI: 0.378-0.768, =0.001; HR: 0.545, 95% CI: 0.364-0.815, =0.003) as independent prognostic factors for both OS and PFS, while SIRI (HR: 0.525, 95% CI: 0.333-0.827, =0.006) was an independent predictor of OS. Nomogram C-indexes for the nomogram of OS were 0.717 and PFS were 0.711, respectively. Survival predictions and actual survival were consistent according to the calibration curve. Our findings suggest that P/PDW is a convenient and effective marker for predicting outcomes in LA-NPC patients.
本研究旨在探讨血小板与血小板分布宽度比值（P/PDW）、全身炎症反应指数（SIRI）和全身免疫炎症指数（SII）在局部晚期鼻咽癌（LA-NPC）患者中的预后意义。本回顾性分析共纳入549例LA-NPC患者。从患者记录中获取临床病理特征和血液检测数据。采用受试者工作特征（ROC）曲线分析确定P/PDW、SIRI和SII的最佳临界值。采用 检验比较临床病理特征。使用Kaplan-Meier法计算生存率。通过Cox回归进行单因素和多因素分析来评估预后因素。此外，我们绘制了一个列线图来预测结局，并使用一致性指数（C-index）和校准曲线评估其准确性。中位随访时间为47.1个月。P/PDW水平升高与N分期进展和疾病进展风险较高相关（均<0.05）。SIRI或SII水平高的患者更有可能出现T分期、临床分期进展以及发生转移（均<0.05）。单因素分析显示，P/PDW、SIRI、SII和T分期与总生存期（OS）和无进展生存期（PFS）均显著相关（均<0.05）。临床分期仅与PFS显著相关（=0.009）。多因素Cox回归分析确定P/PDW（风险比（HR）：0.544，95%置信区间（CI）：0.390-0.759，<0.001；HR：0.406，95%CI：0.268-0.615，<0.001）和T分期（HR：0.539，95%CI：0.378-0.768，=0.001；HR：0.545，95%CI：0.364-0.815，=0.003）是OS和PFS的独立预后因素，而SIRI（HR：0.525，95%CI：0.333-0.827，=0.006）是OS的独立预测因素。OS列线图的C-index为0.717，PFS列线图的C-index为0.711。根据校准曲线，生存预测与实际生存情况一致。我们的研究结果表明，P/PDW是预测LA-NPC患者结局的一种方便有效的标志物。
