Jiang Xi, Zhou Tingting, Liu Chenjing, Xu Na, Chen Xiaobin, Wang Dong
Department of Urology, 900th Hospital of PLA Joint Logistic Support Force, Fuzhou, Fujian, 350025, People's Republic of China.
Department of General Surgery, 900th Hospital of PLA Joint Logistic Support Force, Fuzhou, Fujian, 350025, People's Republic of China.
Int Urol Nephrol. 2025 May 12. doi: 10.1007/s11255-025-04553-8.
This study aimed to evaluate the prognostic value of preoperative systemic immune inflammatory index (SII) and prognostic nutritional index (PNI) in patients with renal cell carcinoma (RCC) undergoing surgery, and to establish a nomogram for predicting overall survival (OS).
We retrospectively analyzed clinical data from 240 RCC patients who underwent surgery. SII and PNI values were calculated, and optimal cutoff value were determined by receiver operating characteristic curves. Patients were classified into high and low SII/PNI groups. Survival outcomes were assessed using Kaplan-Meier analysis and log-rank tests. Univariate and multivariate Cox regression models were used to identify independent prognostic factors, which were incorporated into a nomogram. The model's accuracy and discrimination were evaluated by the consistency index (C-index) and calibration curves.
The 1-, 3- and 5-year survival rates were significantly higher in low SII group were (98.10%, 92.30%, and 87.20%) compared to the high SII group (90.00%, 72.90%, and 57.40%), and higher in the high PNI group (97.60%, 93.00%, and 87.60%) compared to the low PNI group (86.90%, 67.90%, and 40.80%; P < 0.001). Multivariate Cox regression model analysis showed that SII, PNI, hemoglobin, tumor necrosis, surgical method, pathological type, AJCC stage and Fuhrman grade were independent prognostic factors. The nomogram model demonstrated excellent predictive ability with a C index was 0.915.
Preoperative SII and PNI are independent predictors of postoperative prognosis in RCC patients. The constructed nomogram based on multiple factors provides accurate individualized survival predictions.
本研究旨在评估术前全身免疫炎症指数（SII）和预后营养指数（PNI）对接受手术的肾细胞癌（RCC）患者的预后价值，并建立一个预测总生存期（OS）的列线图。
我们回顾性分析了240例接受手术的RCC患者的临床资料。计算SII和PNI值，并通过受试者工作特征曲线确定最佳截断值。将患者分为SII/PNI高、低组。采用Kaplan-Meier分析和对数秩检验评估生存结局。使用单因素和多因素Cox回归模型识别独立预后因素，并将其纳入列线图。通过一致性指数（C指数）和校准曲线评估模型的准确性和辨别力。
低SII组的1年、3年和5年生存率（分别为98.10%、92.30%和87.20%）显著高于高SII组（分别为90.00%、72.90%和57.40%），高PNI组（分别为97.60%、93.00%和87.60%）高于低PNI组（分别为86.90%、67.90%和40.80%；P＜0.001）。多因素Cox回归模型分析显示，SII、PNI、血红蛋白、肿瘤坏死、手术方式、病理类型、美国癌症联合委员会（AJCC）分期和Fuhrman分级是独立预后因素。列线图模型显示出优异的预测能力，C指数为0.915。
术前SII和PNI是RCC患者术后预后的独立预测因素。基于多因素构建的列线图可提供准确的个体化生存预测。
