系统免疫炎症指数与接受新辅助化疗胰腺导管腺癌患者预后的关系

目的 探讨新辅助化疗后系统免疫炎症指数（systemic immune-inflammation index，SII）对胰腺导管腺癌（pancreatic ductal adenocarcinoma，PDAC）预后评估的价值。方法 回顾性分析2013年1月至2016年12月在盘锦辽油宝石花医院行胰腺切除术的PDAC患者的临床资料。新辅助化疗后检测SII，依据ROC曲线确定SII最佳临界值（885）分为SII＞885组（n=37）和SII≤885组（n=58），采用Cox回归评估SII与PDAC患者术后生存的关系。结果 SII与肿瘤大小、胆道引流、术前CA19-9水平有关（P<0.05）。SII≤885组的3年生存率高于SII＞885（43.1% vs 18.9%，P=0.015）。多因素Cox回归显示，肿瘤大小>3 cm（HR=1.367，95%CI：1.227～2.215，P=0.031）、CA19-9>37 IU/mL（HR=1.292，95%CI：1.132～1.931，P=0.011）及SII＞885（HR=1.451，95%CI：1.327～2.431，P=0.021）是影响PDAC患者术后生存的独立危险因素。结论 新辅助化疗后SII高的PDAC患者预后较差且SII＞885提示PDAC患者预后不良。

Relationship between the systemic immune-inflammation index and the prognosis of pancreatic ductal adenocarcinoma patients after neoadjuvant chemotherapy

Objective To investigate the prognostic value of the systemic immune-inflammation index(SII)in pancreatic ductal adenocarcinoma(PDAC)after neoadjuvant chemotherapy.Methods The clinical data of PDAC patients who received pancreatectomy in Panjin Liao Oil Baoshihua Hospital from January 2013 to December 2016 were analyzed retrospectively.SII was detected after neoadjuvant chemotherapy.The ROC curve was used to determine the optimal cutoff value of SII,by which the patients were divided into SII>885 group(n=37)and SII≤885 group(n=58).Cox regression was used to evaluate the relationship between SII and postoperative survival of PDAC patients.Results SII was related to tumor size,biliary drainage,and CA19-9 levels before surgery(P<0.05).The 3-year survival rate of the SII≤885 group was higher than the SII>885 group(43.1%vs 18.9%,P=0.015).Multivariable Cox regression showed that intraoperative tumor size>3 cm(HR=1.367,95%CI:1.227-2.215,P=0.031),CA19-9>37 IU/mL(HR=1.292,95%CI:1.132-1.931,P=0.011),SII>885(HR=1.451,95%CI:1.327-2.431,P=0.021)were independent risk factors of postoperative survival of PDAC patients.Conclusion SII>885 suggests poor prognosis in patients with PDAC after neoadjuvant chemotherapy.